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AAPC CPB Exam Overview:
| Certification Vendor: | AAPC |
| Exam Name: | AAPC Certified Professional Biller (CPB) Certification Exam |
| Exam Number: | CPB |
| Related Certifications: | CPC CPC-A CPMA CPCO |
| Exam Format: | Multiple-choice questions, Closed-book exam (proctored) |
| Real Exam Qty: | Approximately 135 multiple-choice questions |
| Passing Score: | 70% |
| Exam Price: | $399 (AAPC member) / $499 (non-member, subject to change) |
| Available Languages: | English |
| Certificate Validity Period: | Annual maintenance required (continuing education units and membership renewal) |
| Exam Duration: | 300 minutes |
| Recommended Training: | AAPC Medical Billing Training Resources AAPC CPB Training Course |
| Exam Registration: | AAPC Certification Registration AAPC CPB Certification Page |
| Sample Questions: | AAPC CPB Sample Questions |
| Exam Way: | Computer-based, proctored exam (online or designated testing center depending on AAPC arrangements) |
| Pre Condition: | No formal prerequisite required, but knowledge of medical terminology and basic coding/billing concepts is strongly recommended. |
| Official Syllabus URL: | https://www.aapc.com/certifications/cpb/ |
AAPC CPB Exam Syllabus Topics:
| Section | Objectives |
|---|---|
| Compliance and Regulations | - Billing compliance standards - Fraud and abuse prevention - HIPAA and patient privacy rules |
| Medical Billing Fundamentals | - Medical billing workflow and revenue cycle - Insurance types and payer structures - Healthcare reimbursement systems |
| Insurance Processing and Payer Rules | - Medicare and Medicaid guidelines - Coordination of benefits (COB) - Private insurance policies and contracts |
| Coding and Claim Submission Basics | - Use of modifiers and coding compliance - Claims submission processes - ICD-10-CM, CPT, and HCPCS overview |
| Revenue Cycle Management | - Payment posting and reconciliation - Accounts receivable follow-up - Claims denial and rejection management |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. What does it mean by brachy?
A) short
B) tall
2. What does APC stand for?
A) Ambulatory Patient Classification
B) Ambulatory Payment Classification
C) Advanced Payment Classification
D) Advanced Patient Classification
3. 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.
4. What does the acronym E/M stand for in medical coding?
A) Evaluation and Management
B) Explanation of Benefits
C) Electronic Medical Record
D) Electronic Media Claim
5. Allowable Charge
A) See limiting charge; maximum fee a physician may charge.
B) Adopted by Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries; expanded original DRG system (based on intensity of resources) to add two subclasses to each DRG that adjusts Medicare inpatient hospital reimbursement rates for of mortality (ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme.
C) DRG system adapted for use by thirdparty payers to reimburse hospitals for inpatient care provided to nonMedicare beneficiaries (e.g. Blue Cross Blue Shield, commercial health plans, TRICARE); DRG assignment is based on intensity of resources.
D) The Maximum amount the payer will reimburse for each procedure or service, according to the patients policy.
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: B | Question # 3 Answer: C | Question # 4 Answer: A | Question # 5 Answer: A |
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