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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Reimbursement and Collections | 14% | - Accounts receivable management - Payment posting, adjustments - Refunds, payment plans, write-offs - Patient statements, collections |
| Topic 2: Billing Regulations | 13% | - ACOs, NCCI, LCDs, NCDs - Incident-to billing, global packages - CMS-1500, UB-04 completion - Payer payment policies |
| Topic 3: Coding Concepts for Billers | 12% | - ICD-10-CM, CPT®, HCPCS Level II - Code validation, modifiers - Medical necessity |
| Topic 4: Claims and Billing | 14% | - Claim submission, tracking, follow-up - Timely filing rules - Electronic claims, clearinghouses - Denials, appeals, corrections |
| Topic 5: HIPAA and Compliance | 9% | - Compliance programs - Fraud, abuse, False Claims Act - Privacy, security, transaction standards - Medical record retention |
| Topic 6: Case Analysis | 17% | - Adjudication and resolution - End-to-end billing scenarios - Eligibility verification |
| Topic 7: Types of Insurance | 21% | - Medicare, Medigap, Medicaid - TRICARE/CHAMPUS, Workers' compensation - Managed care plans - Third-party liability - Commercial payers |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. The medical word root "fibr" or "fibr/o" refers to:
A) milk
B) fiber
C) stomach
D) before
2. What does the acronym CT stand for?
A) Debt Collection Assistance Officer
B) Computed Tomography
C) Durable Medical Equipment
D) Defense Enrollment Eligibility Reporting System
3. American Academy of Processional Coders (AAPC) is professional association established to provide a national certification and credentialing process, to support the national and local membership by providing educational products and opportunities to network, and to increase and promote national recognition and awareness of professional coding.
A) FALSE
B) TRUE
4. What does the acronym FR stand for?
A) Flexible Spending Account
B) General Enrollment Period
C) Federal Register
D) General Equivalency Mapping
5. The medical word root "ankyl/o" (or "ankyl") means:
A) joint
B) condition
C) against
D) crooked, bent
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: B | Question # 3 Answer: B | Question # 4 Answer: C | Question # 5 Answer: D |
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