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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: ICD-10-CM Diagnosis Coding | 15-20% | - Secondary diagnosis coding - ICD-10-CM structure and conventions - Chapter-specific guidelines - Code accuracy and specificity - Principal diagnosis selection |
| Topic 2: Billing Compliance and Regulations | 10-15% | - Fraud, waste, and abuse prevention - Stark Law and Anti-Kickback Statute basics - Documentation compliance - Appeal and denial management - HIPAA privacy and security requirements |
| Topic 3: Insurance and Reimbursement | 20-25% | - Fee schedules and reimbursement methodologies - Commercial insurance policies - Workers' compensation and no-fault billing - Coordination of benefits - Government payers (Medicare, Medicaid, TRICARE) - Claims submission and processing |
| Topic 4: CPT Coding | 20-25% | - Category II and III codes - Modifiers and their appropriate use - CPT code categories and structure - Evaluation and Management (E/M) codes - Surgical procedure codes |
| Topic 5: Practice Management | 10-15% | - Patient responsibility calculations - Accounts receivable management - Insurance verification processes - Collections and payment posting - Patient registration and demographics |
| Topic 6: Healthcare Billing Fundamentals | 15-20% | - Anatomy and physiology for billers - Healthcare documentation principles - Revenue cycle overview - Medical terminology basics |
AAPC Certified Professional Biller (CPB) Sample Questions:
EDD
- A. Electronic data interchange
- B. (California) Employment Development Department
- C. Electronic funds transfer
- D. Employer group health plan
Correct Answer: B 🗳️
FEP stands for Federal Employee Program.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
Case management services is a process by which an attending physician coordinates and supervises care provided to patient by other providers.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
ARPDRG refers to All Patient Refined DiagnosisRelated Group.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
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