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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Topic 1: Insurance Processing and Payer Rules | - Coordination of benefits (COB) - Medicare and Medicaid guidelines - Private insurance policies and contracts |
| Topic 2: Coding and Claim Submission Basics | - ICD-10-CM, CPT, and HCPCS overview - Claims submission processes - Use of modifiers and coding compliance |
| Topic 3: Medical Billing Fundamentals | - Medical billing workflow and revenue cycle - Healthcare reimbursement systems - Insurance types and payer structures |
| Topic 4: Compliance and Regulations | - HIPAA and patient privacy rules - Fraud and abuse prevention - Billing compliance standards |
| Topic 5: Revenue Cycle Management | - Payment posting and reconciliation - Claims denial and rejection management - Accounts receivable follow-up |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. Which part of the body does cardi refer to?
A) neck
B) head
C) vagina
D) heart
2. Which document is mailed by the payer to the patient to illustrate the reimbrsement amount of a covered benefit?
A) Health Insurance Claim
B) Hold Harmless Clause
C) Explanation of Benefits
D) Centers of Medicare and Medicaid Services150 (CMS1500)
3. HSA stands for Health Savings account.
A) TRUE
B) FALSE
4. What does CDT stand for?
A) Civilian Dental Terminology
B) Conversion Dental Terminology
C) Comprehensive Dental Terminology
D) Current Dental Terminology
5. Which professional association was founded to improve the quality of medical records and current advances toward an electronic and global environment including the implementation of ICD10CM
A) American Health Information Management Association (AHIMA)
B) Joint venture between Blue Cross and Blue shield where the corporations shared one building and computer services but maintained separate corporate identities
C) American Academy of Professional Coders (AAPC)
D) An association of independent Blue Cross Blue Shield plans
Solutions:
| Question # 1 Answer: D | Question # 2 Answer: C | Question # 3 Answer: A | Question # 4 Answer: D | Question # 5 Answer: A |
