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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Case Analysis | 17% | - Eligibility verification - Adjudication and resolution - End-to-end billing scenarios |
| HIPAA and Compliance | 9% | - Medical record retention - Fraud, abuse, False Claims Act - Privacy, security, transaction standards - Compliance programs |
| Coding Concepts for Billers | 12% | - ICD-10-CM, CPT®, HCPCS Level II - Code validation, modifiers - Medical necessity |
| Reimbursement and Collections | 14% | - Payment posting, adjustments - Accounts receivable management - Refunds, payment plans, write-offs - Patient statements, collections |
| Billing Regulations | 13% | - Incident-to billing, global packages - CMS-1500, UB-04 completion - ACOs, NCCI, LCDs, NCDs - Payer payment policies |
| Types of Insurance | 21% | - Commercial payers - Managed care plans - TRICARE/CHAMPUS, Workers' compensation - Third-party liability - Medicare, Medigap, Medicaid |
| Claims and Billing | 14% | - Denials, appeals, corrections - Timely filing rules - Claim submission, tracking, follow-up - Electronic claims, clearinghouses |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. What does it mean by dextr?
A) right
B) left
2. HHRG stands for Home Health Resource Group.
A) TRUE
B) FALSE
3. de
A) skin
B) right
C) half
D) lack of, down
4. Blue Worldwide Expat __________
A) provides global medical coverage for active employees and their dependents who spend more than six months outside the United States for six months or more is eligible for Blue World Expat.
B) provides global medical coverage for active employees and their dependents who spend more than six months outside the United States for three months or more is eligible for Blue World Expat.
C) provides global medical coverage for active employees and their dependents who spend more than three months outside the United States for three months or more is eligible for Blue World Expat.
D) provides global medical coverage for active employees and their dependents who spend more than three months outside the United States for six months or more is eligible for Blue World Expat.
5. Case mix includes the types and categories of patients treated by a healthcare provider.
A) TRUE
B) FALSE
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: A | Question # 3 Answer: D | Question # 4 Answer: A | Question # 5 Answer: A |





