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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Insurance and Reimbursement | 20-25% | - Commercial insurance policies - Claims submission and processing - Workers' compensation and no-fault billing - Fee schedules and reimbursement methodologies - Coordination of benefits - Government payers (Medicare, Medicaid, TRICARE) |
| Practice Management | 10-15% | - Collections and payment posting - Patient responsibility calculations - Patient registration and demographics - Insurance verification processes - Accounts receivable management |
| Billing Compliance and Regulations | 10-15% | - Documentation compliance - Stark Law and Anti-Kickback Statute basics - Fraud, waste, and abuse prevention - HIPAA privacy and security requirements - Appeal and denial management |
| CPT Coding | 20-25% | - Surgical procedure codes - CPT code categories and structure - Category II and III codes - Evaluation and Management (E/M) codes - Modifiers and their appropriate use |
| ICD-10-CM Diagnosis Coding | 15-20% | - Chapter-specific guidelines - Principal diagnosis selection - ICD-10-CM structure and conventions - Code accuracy and specificity - Secondary diagnosis coding |
| Healthcare Billing Fundamentals | 15-20% | - Healthcare documentation principles - Medical terminology basics - Anatomy and physiology for billers - Revenue cycle overview |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. Which part of the body do gaster and gastr refer to?
A) tongue
B) intestine
C) stomach
D) genitals
2. What does AHA stand for?
A) American Healthcare Association
B) American Hostel Association
C) American Hospital Association
D) American Hospitality Association
3. Which of the following suffixes does NOT mean blood?
A) hem
B) dacry
C) hema
D) hemat
4. ABN stands for Advance Beneficiary Notice.
A) FALSE
B) TRUE
5. di
A) pain
B) bad, painful
C) separation
D) two
Solutions:
| Question # 1 Answer: C | Question # 2 Answer: C | Question # 3 Answer: B | Question # 4 Answer: B | Question # 5 Answer: D |
Ken 
Benson 
Yehudi 
Catherine 
Blake 
Suzanne 
Gloria 
Jesse 
Claire 
Carl 
Kennedy 
Naomi 
