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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Healthcare Billing Fundamentals | 15-20% | - Healthcare documentation principles - Revenue cycle overview - Medical terminology basics - Anatomy and physiology for billers |
| Topic 2: Billing Compliance and Regulations | 10-15% | - Documentation compliance - Appeal and denial management - Stark Law and Anti-Kickback Statute basics - HIPAA privacy and security requirements - Fraud, waste, and abuse prevention |
| Topic 3: ICD-10-CM Diagnosis Coding | 15-20% | - Principal diagnosis selection - ICD-10-CM structure and conventions - Secondary diagnosis coding - Chapter-specific guidelines - Code accuracy and specificity |
| Topic 4: CPT Coding | 20-25% | - Surgical procedure codes - Modifiers and their appropriate use - Category II and III codes - CPT code categories and structure - Evaluation and Management (E/M) codes |
| Topic 5: Insurance and Reimbursement | 20-25% | - Claims submission and processing - Workers' compensation and no-fault billing - Government payers (Medicare, Medicaid, TRICARE) - Coordination of benefits - Commercial insurance policies - Fee schedules and reimbursement methodologies |
| Topic 6: Practice Management | 10-15% | - Accounts receivable management - Patient registration and demographics - Collections and payment posting - Patient responsibility calculations - Insurance verification processes |
AAPC Certified Professional Biller (CPB) Sample Questions:
What does it mean by dis?
- A. separation
- B. combination
Correct Answer: A 🗳️
What does AHIMA stand for?
- A. Australian Health Information Management Association
- B. American Health Information Management Association
- C. African Health Information Management Association
- D. Asian Health Information Management Association
Correct Answer: B 🗳️
HSSA stands for Health Savings Security Account.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
Case law is also common law; based on a court decision that establishes a precedent.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
