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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Revenue Cycle Management | - Payment posting and reconciliation - Accounts receivable follow-up - Claims denial and rejection management |
| Medical Billing Fundamentals | - Medical billing workflow and revenue cycle - Healthcare reimbursement systems - Insurance types and payer structures |
| Coding and Claim Submission Basics | - Use of modifiers and coding compliance - ICD-10-CM, CPT, and HCPCS overview - Claims submission processes |
| Insurance Processing and Payer Rules | - Coordination of benefits (COB) - Private insurance policies and contracts - Medicare and Medicaid guidelines |
| Compliance and Regulations | - Billing compliance standards - Fraud and abuse prevention - HIPAA and patient privacy rules |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. blephar
A) eyelid
B) short
C) condition
D) slow
2. DMEPOS
A) Department of Defense
B) Durable Medical Equipment, Prosthetic and Orthotic Supplies
C) Durable Medical Equipment regional carriers
D) Diagnosis related groups
3. What does it mean by cry?
A) cold
B) hot
C) cool
D) warm
4. Adjudication
A) Payment correction resulting in additional payment(s) to the provider.
B) Document that acknowledges patient responsibility for payment if Medicare denies the claim
C) Judicial dispute resolution process in which an appeals board makes a final determination.
D) Also called adverse reaction; the appearance of a pathologic condition due to ingestion r exposure to a chemical substance properly administered or taken.
5. Amendment to the HMO Act of 1973 is legislation that allowed federally qualified HMOs to permit members to occasionally use non HMO physicians and be partially reimbursed.
A) FALSE
B) TRUE
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: B | Question # 3 Answer: A | Question # 4 Answer: C | Question # 5 Answer: B |
