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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: ICD-10-CM Diagnosis Coding | 15-20% | - Code accuracy and specificity - ICD-10-CM structure and conventions - Principal diagnosis selection - Chapter-specific guidelines - Secondary diagnosis coding |
| Topic 2: Practice Management | 10-15% | - Patient responsibility calculations - Patient registration and demographics - Insurance verification processes - Collections and payment posting - Accounts receivable management |
| Topic 3: Billing Compliance and Regulations | 10-15% | - Appeal and denial management - Fraud, waste, and abuse prevention - Stark Law and Anti-Kickback Statute basics - Documentation compliance - HIPAA privacy and security requirements |
| Topic 4: Healthcare Billing Fundamentals | 15-20% | - Anatomy and physiology for billers - Healthcare documentation principles - Revenue cycle overview - Medical terminology basics |
| Topic 5: CPT Coding | 20-25% | - CPT code categories and structure - Evaluation and Management (E/M) codes - Modifiers and their appropriate use - Surgical procedure codes - Category II and III codes |
| Topic 6: Insurance and Reimbursement | 20-25% | - Government payers (Medicare, Medicaid, TRICARE) - Claims submission and processing - Fee schedules and reimbursement methodologies - Workers' compensation and no-fault billing - Commercial insurance policies - Coordination of benefits |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. DEERS
A) Durable Medical Equipment regional carriers
B) Durable Medical Equipment, Prosthetic and Orthotic Supplies
C) Defense Enrollment Eligibility Reporting System
D) Durable Medical Equipment
2. Case mix includes the types and categories of patients treated by a healthcare provider.
A) FALSE
B) TRUE
3. What does AHIMA stand for?
A) African Health Information Management Association
B) Asian Health Information Management Association
C) American Health Information Management Association
D) Australian Health Information Management Association
4. What does AMA stand for?
A) American Management Association
B) American Medical Association
C) American Military Association
5. HCPCS stands for Healthcare Common Procedure Coding System.
A) FALSE
B) TRUE
Solutions:
| Question # 1 Answer: C | Question # 2 Answer: B | Question # 3 Answer: C | Question # 4 Answer: B | Question # 5 Answer: B |
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