PDF Version DemoAAPC 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 |
| Real Exam Qty: | 135 |
| Passing Score: | 70% |
| Related Certifications: | Certified Physician Practice Manager (CPPM) Certified Compliance Officer (CPCO) Certified Professional Coder (CPC) |
| Available Languages: | English |
| Exam Price: | $399 (members), $599 (non-members); $499 for two attempts |
| Certificate Validity Period: | 2 years (requires 36 CEUs and active membership for renewal) |
| Exam Format: | Scenario-based, Multiple-choice, Proctored |
| Recommended Training: | CPB Official Training Course CPB Study Guide |
| 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 |
|---|---|---|
| Billing Regulations | 13% | - Incident-to billing, global packages - CMS-1500, UB-04 completion - Payer payment policies - ACOs, NCCI, LCDs, NCDs |
| Claims and Billing | 14% | - Electronic claims, clearinghouses - Timely filing rules - Claim submission, tracking, follow-up - Denials, appeals, corrections |
| Case Analysis | 17% | - Adjudication and resolution - End-to-end billing scenarios - Eligibility verification |
| HIPAA and Compliance | 9% | - Compliance programs - Privacy, security, transaction standards - Fraud, abuse, False Claims Act - Medical record retention |
| Reimbursement and Collections | 14% | - Accounts receivable management - Payment posting, adjustments - Refunds, payment plans, write-offs - Patient statements, collections |
| Types of Insurance | 21% | - Third-party liability - Medicare, Medigap, Medicaid - TRICARE/CHAMPUS, Workers' compensation - Managed care plans - Commercial payers |
| Coding Concepts for Billers | 12% | - Code validation, modifiers - Medical necessity - ICD-10-CM, CPT®, HCPCS Level II |
AAPC Certified Professional Biller (CPB) Sample Questions:
Question 1
Which part of the body does crani refer to?
A. skeleton
B. skull
C. bones
Question 2
What does it mean by dextr?
A. right
B. left
Question 3
BlueCard Program is program that allows BCBS subscribers to receive local Blue Plan healthcare benefits while traveling or living outside of their plan's area.
A. TRUE
B. FALSE
Question 4
HIPPS stands for Health Insurance Prospective Payment System (code set).
A. TRUE
B. FALSE
Question 5
Blue Cross Blue Shield (BCBS) is joint venture between Blue Cross and Blue Shield where the corporation shared one building and computer.
A. TRUE
B. FALSE
Solutions:
| Question 1 Answer: B | Question 2 Answer: A | Question 3 Answer: A | Question 4 Answer: A | Question 5 Answer: A |
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