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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Topic 1: Compliance and Regulations | - Billing compliance standards - HIPAA and patient privacy rules - Fraud and abuse prevention |
| Topic 2: Insurance Processing and Payer Rules | - Coordination of benefits (COB) - Medicare and Medicaid guidelines - Private insurance policies and contracts |
| Topic 3: Coding and Claim Submission Basics | - Use of modifiers and coding compliance - ICD-10-CM, CPT, and HCPCS overview - Claims submission processes |
| Topic 4: Medical Billing Fundamentals | - Insurance types and payer structures - Medical billing workflow and revenue cycle - 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. dactyl
A) skin
B) lack of, down
C) fingers, toes
D) half
2. Benefit period (Medicare) __________
A) begins with the first day of hospitalization and ends when the patient has been out of the hospital for 60 consecutive days.
B) begins with the first day of hospitalization and ends when the patient has been out of the hospital for 120 consecutive days.
C) begins with the first day of hospitalization and ends when the patient has been out of the hospital for 30 consecutive days.
D) begins with the first day of hospitalization and ends when the patient has been out of the hospital for 90 consecutive days.
3. Advance Beneficiary Notice (ABN) is document that acknowledges patient responsibility for payment if Medicare denies the claim.
A) FALSE
B) TRUE
4. What does the acronym CT stand for?
A) Debt Collection Assistance Officer
B) Defense Enrollment Eligibility Reporting System
C) Durable Medical Equipment
D) Computed Tomography
5. abdomin
A) extremities, top
B) toward
C) abdomen
Solutions:
| Question # 1 Answer: C | Question # 2 Answer: A | Question # 3 Answer: B | Question # 4 Answer: D | Question # 5 Answer: C |
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