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AAPC CPB Exam Syllabus Topics:

SectionObjectives
Topic 1: Compliance and Regulations- Billing compliance standards
- Fraud and abuse prevention
- HIPAA and patient privacy rules
Topic 2: Revenue Cycle Management- Payment posting and reconciliation
- Accounts receivable follow-up
- Claims denial and rejection management
Topic 3: Coding and Claim Submission Basics- ICD-10-CM, CPT, and HCPCS overview
- Claims submission processes
- Use of modifiers and coding compliance
Topic 4: Medical Billing Fundamentals- Healthcare reimbursement systems
- Insurance types and payer structures
- Medical billing workflow and revenue cycle
Topic 5: Insurance Processing and Payer Rules- Coordination of benefits (COB)
- Private insurance policies and contracts
- Medicare and Medicaid guidelines

AAPC Certified Professional Biller (CPB) Sample Questions:

1. CAC (Choose two.)

A) Computerized Axial Tomography
B) Computer Assisted Coding
C) Common Access Card
D) Certified Coding Specialist


2. What does AHIMA stand for?

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


3. What does AHA stand for?

A) American Hospital Association
B) American Hospitality Association
C) American Healthcare Association
D) American Hostel Association


4. Case law is also common law; based on a court decision that establishes a precedent.

A) TRUE
B) FALSE


5. EQRO

A) Electronic Remittance Advice
B) Employee Retirements income security Act of 1974
C) First Look Analysis for Hospital Outlier Monitoring
D) External Quality Review Organization


Solutions:

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

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