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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: | Scenario-based, Multiple-choice, 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:
Question #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
Correct Answer: A 🗳️
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Question #2
HIPPS stands for Health Insurance Prospective Payment System (code set).
- A. TRUE
- B. FALSE
Correct Answer: A 🗳️
Question #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)
Correct Answer: C 🗳️
Question #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
Correct Answer: B 🗳️
Question #5
DSH
- A. Disproportionate share hospital (adjustment)
- B. (California) Employment Development Department
- C. Electronic data interchange
- D. Diagnostic and statistical manual
Correct Answer: A 🗳️
By Chasel
