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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Insurance Processing and Payer Rules | - Coordination of benefits (COB) - Private insurance policies and contracts - Medicare and Medicaid guidelines |
| Revenue Cycle Management | - Payment posting and reconciliation - Claims denial and rejection management - Accounts receivable follow-up |
| Compliance and Regulations | - Fraud and abuse prevention - Billing compliance standards - HIPAA and patient privacy rules |
| Medical Billing Fundamentals | - Insurance types and payer structures - Medical billing workflow and revenue cycle - Healthcare reimbursement systems |
| Coding and Claim Submission Basics | - Use of modifiers and coding compliance - Claims submission processes - ICD-10-CM, CPT, and HCPCS overview |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. CRI
A) Customized SubCapitation Plan
B) Computed Tomography
C) Debt Collection Assistance Officer
D) CHAMPUS Reform Initiative
2. contra
A) skull
B) against, opposite
C) cold
D) blue
3. What are Category III codes?
A) Temporary codes for data collection purposes that are assigned an alphanumeric identifier with a letter in the last field (e.g., 0001T) these codes are located after the Medicine section, and will be archived after five years unless accepted for placement within Category I sections of CPT.
B) Optional performance measurement tracking codes that are field (e,g.,1234A); these codes will be located after the medicine section; their use is optional.
C) Procedures/ services identified by a five digit CPT code and descriptor nomenclature; these codes are traditionally associated with CPT and organized within six sections.
4. Which term refers to a digital version of a patient's paper chart, encompassing a comprehensive record of patient health information?
A) Electronic Medical Record
B) Early and Periodic screening, diagnostic, and treatment
C) Explanation of Benefits
D) Exclusive provider organization
5. What are black box edits?
A) Published code edits, which were discontinued in 2001.
B) Nonpublished code edits, which were discontinued in 2000.
C) Published code edits, which were discontinued in 2000.
D) Nonpublished code edits, which were discontinued in 2001.
Solutions:
| Question # 1 Answer: D | Question # 2 Answer: B | Question # 3 Answer: A | Question # 4 Answer: A | Question # 5 Answer: B |
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