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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Topic 1: Insurance Processing and Payer Rules | - Medicare and Medicaid guidelines - Private insurance policies and contracts - Coordination of benefits (COB) |
| Topic 2: Compliance and Regulations | - Billing compliance standards - HIPAA and patient privacy rules - Fraud and abuse prevention |
| 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: Medical Billing Fundamentals | - Medical billing workflow and revenue cycle - Insurance types and payer structures - Healthcare reimbursement systems |
| Topic 5: Revenue Cycle Management | - Accounts receivable follow-up - Payment posting and reconciliation - Claims denial and rejection management |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. What does it mean by adip?
A) thin
B) fat
2. APDRG refers to All Patient DiagnosisRelated Group.
A) FALSE
B) TRUE
3. Blue Cross Blue Shield Association (BCBSA) is an association of independent Blue Cross Blue Shield plans.
A) FALSE
B) TRUE
4. Benefit period (Medicare) __________
A) begins with the first day of hospitalization and ends when the patient has been out of the hospital for 30 consecutive days.
B) begins with the first day of hospitalization and ends when the patient has been out of the hospital for 90 consecutive days.
C) begins with the first day of hospitalization and ends when the patient has been out of the hospital for 120 consecutive days.
D) begins with the first day of hospitalization and ends when the patient has been out of the hospital for 60 consecutive days.
5. What does CF stand for?
A) Competitive Factor
B) Civilian FactorAffairs
C) Conversion Factor
D) Clinical Factor
Solutions:
| Question # 1 Answer: B | Question # 2 Answer: B | Question # 3 Answer: B | Question # 4 Answer: D | Question # 5 Answer: C |




