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AAPC CPB Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: ICD-10-CM Diagnosis Coding15-20%- Secondary diagnosis coding
- Principal diagnosis selection
- ICD-10-CM structure and conventions
- Chapter-specific guidelines
- Code accuracy and specificity
Topic 2: CPT Coding20-25%- Category II and III codes
- Modifiers and their appropriate use
- CPT code categories and structure
- Surgical procedure codes
- Evaluation and Management (E/M) codes
Topic 3: Billing Compliance and Regulations10-15%- Stark Law and Anti-Kickback Statute basics
- Documentation compliance
- Appeal and denial management
- Fraud, waste, and abuse prevention
- HIPAA privacy and security requirements
Topic 4: Insurance and Reimbursement20-25%- Coordination of benefits
- Fee schedules and reimbursement methodologies
- Commercial insurance policies
- Government payers (Medicare, Medicaid, TRICARE)
- Claims submission and processing
- Workers' compensation and no-fault billing
Topic 5: Practice Management10-15%- Accounts receivable management
- Collections and payment posting
- Patient registration and demographics
- Patient responsibility calculations
- Insurance verification processes
Topic 6: Healthcare Billing Fundamentals15-20%- Medical terminology basics
- Healthcare documentation principles
- Anatomy and physiology for billers
- Revenue cycle overview

AAPC Certified Professional Biller (CPB) Sample Questions:

1. What does the acronym E/M stand for in medical coding?

A) Explanation of Benefits
B) Electronic Medical Record
C) Electronic Media Claim
D) Evaluation and Management


2. CPC

A) CHAMPUS Reform Initiative
B) Current Procedural Terminology
C) Customized SubCapitation Plan
D) Certified Professional Coder


3. CHAMPUS stands for Civilian Health and Medical Program of Veterans Affairs.

A) FALSE
B) TRUE


4. What does AHIMA stand for?

A) Australian Health Information Management Association
B) African Health Information Management Association
C) Asian Health Information Management Association
D) American Health Information Management Association


5. What does the acronym EHR stand for?

A) Electronic Medical Record
B) Electronic Media Claim
C) Electronic Health Record
D) Evaluation and Management


Solutions:

Question # 1
Answer: D
Question # 2
Answer: D
Question # 3
Answer: B
Question # 4
Answer: D
Question # 5
Answer: C

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