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AAPC CPB Exam Overview:
| Certification Vendor: | American Academy of Professional Coders (AAPC) |
| Exam Name: | Certified Professional Biller (CPB) Certification Exam |
| Exam Number: | CPB |
| Exam Duration: | 240 minutes |
| Related Certifications: | Certified Professional Coder (CPC) Certified Physician Practice Manager (CPPM) Certified Compliance Officer (CPCO) |
| Certificate Validity Period: | 2 years (requires 36 CEUs and active membership for renewal) |
| Real Exam Qty: | 135 |
| Exam Format: | Multiple-choice, Scenario-based, Proctored |
| Exam Price: | $399 (members), $599 (non-members); $499 for two attempts |
| Passing Score: | 70% |
| Available Languages: | English |
| Recommended Training: | CPB Study Guide CPB Official Training Course |
| Exam Registration: | AAPC Official Registration |
| Sample Questions: | AAPC CPB Sample Questions |
| Exam Way: | Online remote proctored or in-person at authorized testing centers |
| Pre Condition: | Active AAPC membership required; recommended knowledge of medical terminology, anatomy, and pathophysiology; 2 years of experience recommended (CPB-A awarded without experience) |
| Official Syllabus URL: | https://www.aapc.com/certifications/cpb/ |
AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Case Analysis | 17% | - Eligibility verification - Adjudication and resolution - End-to-end billing scenarios |
| Topic 2: Billing Regulations | 13% | - ACOs, NCCI, LCDs, NCDs - Payer payment policies - CMS-1500, UB-04 completion - Incident-to billing, global packages |
| Topic 3: Types of Insurance | 21% | - Managed care plans - Medicare, Medigap, Medicaid - Third-party liability - Commercial payers - TRICARE/CHAMPUS, Workers' compensation |
| Topic 4: Reimbursement and Collections | 14% | - Accounts receivable management - Refunds, payment plans, write-offs - Payment posting, adjustments - Patient statements, collections |
| Topic 5: HIPAA and Compliance | 9% | - Privacy, security, transaction standards - Fraud, abuse, False Claims Act - Compliance programs - Medical record retention |
| Topic 6: Coding Concepts for Billers | 12% | - ICD-10-CM, CPT®, HCPCS Level II - Medical necessity - Code validation, modifiers |
| Topic 7: Claims and Billing | 14% | - Denials, appeals, corrections - Timely filing rules - Electronic claims, clearinghouses - Claim submission, tracking, follow-up |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. What is the main purpose of an audit in medical billing?
A) Ensure billing accuracy and compliance
B) Increase workload
C) Speed up reimbursements
D) Punish billers
2. HIPPS stands for Health Insurance Prospective Payment System (code set).
A) TRUE
B) FALSE
3. Which professional association was founded to improve the quality of medical records and current advances toward an electronic and global environment including the implementation of ICD10CM
A) Joint venture between Blue Cross and Blue shield where the corporations shared one building and computer services but maintained separate corporate identities
B) An association of independent Blue Cross Blue Shield plans
C) American Health Information Management Association (AHIMA)
D) American Academy of Professional Coders (AAPC)
4. CMS1500
A) Clinical nurse specialist
B) Insurance claim used by noninstitutional providers and supplier to bill payers
C) Coordination of Benefits
D) Consolidated Omnibus Budget Reconciliation Act of 1985
5. DSH
A) Disproportionate share hospital (adjustment)
B) (California) Employment Development Department
C) Electronic data interchange
D) Diagnostic and statistical manual
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: A | Question # 3 Answer: C | Question # 4 Answer: B | Question # 5 Answer: A |
By Bard
