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AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Insurance Processing and Payer Rules | - Medicare and Medicaid guidelines - Private insurance policies and contracts - Coordination of benefits (COB) |
| Coding and Claim Submission Basics | - Claims submission processes - ICD-10-CM, CPT, and HCPCS overview - Use of modifiers and coding compliance |
| Medical Billing Fundamentals | - Insurance types and payer structures - Healthcare reimbursement systems - Medical billing workflow and revenue cycle |
| Revenue Cycle Management | - Accounts receivable follow-up - Claims denial and rejection management - Payment posting and reconciliation |
| Compliance and Regulations | - Billing compliance standards - HIPAA and patient privacy rules - Fraud and abuse prevention |
AAPC Certified Professional Biller (CPB) Sample Questions:
Care plan oversight services cover the physician's time supervising a complex and multidisciplinary care treatment program for specific patient who is under the care of a home health agency, hospice, or nursing facility.
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
CLIA
- A. UB04 Claim used by institutional and other selected providers to bill payers
- B. Clinical Laboratory Improvement Act
- C. Competitive Medical Plan
- D. Centers of Medicare and Medicaid Services
Correct Answer: B 🗳️
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. TRUE
- B. FALSE
Correct Answer: A 🗳️
CPT
- A. Computed Tomography
- B. CHAMPUS Reform Initiative
- C. Customized SubCapitation Plan
- D. Current Procedural Terminology
Correct Answer: D 🗳️
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