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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 | - HIPAA and patient privacy rules - Billing compliance standards - Fraud and abuse prevention |
| Topic 3: Revenue Cycle Management | - Payment posting and reconciliation - Claims denial and rejection management - Accounts receivable follow-up |
| Topic 4: Medical Billing Fundamentals | - Healthcare reimbursement systems - Insurance types and payer structures - Medical billing workflow and revenue cycle |
| Topic 5: Insurance Processing and Payer Rules | - Private insurance policies and contracts - Medicare and Medicaid guidelines - Coordination of benefits (COB) |
AAPC Certified Professional Biller (CPB) Sample Questions:
Current Procedural Terminology (CPT) is used to report professional services to payers.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
Blue Cross Blue Shield Association (BCBSA) is an association of independent Blue Cross Blue Shield plans.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
Catchment area is the region defined by code boundaries within a 40mile radius of a military treatment facility.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
HEDIS stands for Health Plan Employer Data and Information Set.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
CHAMPUS stands for Civilian Health and Medical Program of Veterans Affairs.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
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