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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Topic 1: Coding and Claim Submission Basics | - ICD-10-CM, CPT, and HCPCS overview - Claims submission processes - Use of modifiers and coding compliance |
| Topic 2: Compliance and Regulations | - Billing compliance standards - Fraud and abuse prevention - HIPAA and patient privacy rules |
| Topic 3: Revenue Cycle Management | - Accounts receivable follow-up - Claims denial and rejection management - Payment posting and reconciliation |
| Topic 4: Medical Billing Fundamentals | - Healthcare reimbursement systems - Medical billing workflow and revenue cycle - Insurance types and payer structures |
| Topic 5: Insurance Processing and Payer Rules | - Medicare and Medicaid guidelines - Coordination of benefits (COB) - Private insurance policies and contracts |
AAPC Certified Professional Biller (CPB) Sample Questions:
Question 1
Which term refers to a digital version of a patient's paper chart, encompassing a comprehensive record of patient health information?
A. Explanation of Benefits
B. Early and Periodic screening, diagnostic, and treatment
C. Exclusive provider organization
D. Electronic Medical Record
Question 2
Birthday rule determines coverage by primary and secondary policies when each parent subscribes to a different health insurance plan.
A. FALSE
B. TRUE
Question 3
CAT stands for Computerized Axial Tomography.
A. FALSE
B. TRUE
Question 4
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 Academy of Professional Coders (AAPC)
B. An association of independent Blue Cross Blue Shield plans
C. Joint venture between Blue Cross and Blue shield where the corporations shared one building and computer services but maintained separate corporate identities
D. American Health Information Management Association (AHIMA)
Question 5
Carcinoma (Ca) in situ is a malignant tumor that is localized, circumscribed, encapsulated, and noninvasive (has not spread to deeper or adjacent tissues or organs).
A. FALSE
B. TRUE
Solutions:
| Question 1 Answer: D | Question 2 Answer: B | Question 3 Answer: B | Question 4 Answer: D | Question 5 Answer: B |
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