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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Topic 1: Compliance and Regulations | - Fraud and abuse prevention - HIPAA and patient privacy rules - Billing compliance standards |
| Topic 2: Medical Billing Fundamentals | - Healthcare reimbursement systems - Insurance types and payer structures - Medical billing workflow and revenue cycle |
| Topic 3: Coding and Claim Submission Basics | - Claims submission processes - Use of modifiers and coding compliance - ICD-10-CM, CPT, and HCPCS overview |
| Topic 4: Revenue Cycle Management | - Accounts receivable follow-up - Payment posting and reconciliation - Claims denial and rejection management |
| Topic 5: Insurance Processing and Payer Rules | - Medicare and Medicaid guidelines - Private insurance policies and contracts - Coordination of benefits (COB) |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. EGHP
A) Electronic Healthcare Network Accreditation Commission
B) Employer group health plan
C) Electronic Health Record
D) Evaluation and Management
2. What does CF stand for?
A) Conversion Factor
B) Competitive Factor
C) Civilian FactorAffairs
D) Clinical Factor
3. The medical word root "hemat" or "hemat/o" refers to:
A) blood
B) half
C) below, under
D) liver
4. A patient has Medicare as primary and a commercial plan as secondary. Which insurance should be billed first?
A) Secondary insurance
B) Medicaid
C) Medicare
D) Commercial insurance
5. Ambulatory Payment Classification (APC) is prospective payment system used to calculate reimbursement for outpatient care according to similar clinical characteristics and in terms of resources required.
A) FALSE
B) TRUE
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: A | Question # 3 Answer: A | Question # 4 Answer: C | Question # 5 Answer: B |






