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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: CPT Coding | 20-25% | - Modifiers and their appropriate use - CPT code categories and structure - Surgical procedure codes - Category II and III codes - Evaluation and Management (E/M) codes |
| Topic 2: Billing Compliance and Regulations | 10-15% | - Stark Law and Anti-Kickback Statute basics - Documentation compliance - Appeal and denial management - Fraud, waste, and abuse prevention - HIPAA privacy and security requirements |
| Topic 3: Practice Management | 10-15% | - Insurance verification processes - Patient responsibility calculations - Accounts receivable management - Patient registration and demographics - Collections and payment posting |
| Topic 4: Healthcare Billing Fundamentals | 15-20% | - Medical terminology basics - Healthcare documentation principles - Revenue cycle overview - Anatomy and physiology for billers |
| Topic 5: Insurance and Reimbursement | 20-25% | - Commercial insurance policies - Workers' compensation and no-fault billing - Government payers (Medicare, Medicaid, TRICARE) - Claims submission and processing - Fee schedules and reimbursement methodologies - Coordination of benefits |
| Topic 6: ICD-10-CM Diagnosis Coding | 15-20% | - ICD-10-CM structure and conventions - Principal diagnosis selection - Chapter-specific guidelines - Secondary diagnosis coding - Code accuracy and specificity |
AAPC Certified Professional Biller (CPB) Sample Questions:
Which part of the body does cervic refer to?
- A. neck
- B. skull
- C. vagina
- D. head
Correct Answer: A 🗳️
HICN stands for Health Insurance claim number.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
HPSA stands for Health Personnel Shortage Area.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
EPSDT
- A. Electronic Remittance Advice
- B. Employee Retirements income security Act of 1974
- C. Early and Periodic screening, diagnostic, and treatment
- D. External Quality Review Organization
Correct Answer: C 🗳️

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