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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Revenue Cycle Management | - Accounts receivable follow-up - Claims denial and rejection management - Payment posting and reconciliation |
| Coding and Claim Submission Basics | - Use of modifiers and coding compliance - ICD-10-CM, CPT, and HCPCS overview - Claims submission processes |
| Compliance and Regulations | - Fraud and abuse prevention - HIPAA and patient privacy rules - Billing compliance standards |
| Medical Billing Fundamentals | - Medical billing workflow and revenue cycle - Insurance types and payer structures - Healthcare reimbursement systems |
| Insurance Processing and Payer Rules | - Coordination of benefits (COB) - Private insurance policies and contracts - Medicare and Medicaid guidelines |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. What is Blue Cross (BC)?
A) Insurance plan created in 1929 when Baylor University Hospital, in Dallas, TX, approached teachers in Dallas school district with a plan that guaranteed up to 21 days of hospitalization per year for subscribers and each dependent for a $6 annual premium.
B) Insurance plan created in 1929 when Baylor University Hospital, in Dallas, TX, approached teachers in Dallas school district with a plan that guaranteed up to 20 days of hospitalization per year for subscribers and each dependent for a $6 annual premium.
C) Insurance plan created in 1930 when Baylor University Hospital, in Dallas, TX, approached teachers in Dallas school district with a plan that guaranteed up to 21 days of hospitalization per year for subscribers and each dependent for a $6 annual premium.
D) Insurance plan created in 1930 when Baylor University Hospital, in Dallas, TX, approached teachers in Dallas school district with a plan that guaranteed up to 20 days of hospitalization per year for subscribers and each dependent for a $6 annual premium.
2. The medical word root "ileo" refers to the:
A) ilium (hip bone)
B) ileum (small intestine)
C) within, into
D) in, into, not
3. The medical word root "ankyl/o" (or "ankyl") means:
A) crooked, bent
B) joint
C) against
D) condition
4. What does the acronym E/M stand for in medical coding?
A) Electronic Media Claim
B) Evaluation and Management
C) Electronic Medical Record
D) Explanation of Benefits
5. DOD
A) Diagnostic and statistical manual
B) Disproportionate share hospital (adjustment)
C) Diagnosis related groups
D) Department of Defense
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: B | Question # 3 Answer: A | Question # 4 Answer: B | Question # 5 Answer: D |
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