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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 |
| Real Exam Qty: | 135 |
| Certificate Validity Period: | 2 years (requires 36 CEUs and active membership for renewal) |
| Passing Score: | 70% |
| Exam Duration: | 240 minutes |
| Related Certifications: | Certified Professional Coder (CPC) Certified Physician Practice Manager (CPPM) Certified Compliance Officer (CPCO) |
| Exam Price: | $399 (members), $599 (non-members); $499 for two attempts |
| Exam Format: | Multiple-choice, Scenario-based, Proctored |
| Available Languages: | English |
| 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 |
|---|---|---|
| Topic 1: Coding Concepts for Billers | 12% | - ICD-10-CM, CPT®, HCPCS Level II - Medical necessity - Code validation, modifiers |
| Topic 2: Reimbursement and Collections | 14% | - Patient statements, collections - Payment posting, adjustments - Accounts receivable management - Refunds, payment plans, write-offs |
| Topic 3: Billing Regulations | 13% | - ACOs, NCCI, LCDs, NCDs - Payer payment policies - CMS-1500, UB-04 completion - Incident-to billing, global packages |
| Topic 4: HIPAA and Compliance | 9% | - Medical record retention - Fraud, abuse, False Claims Act - Compliance programs - Privacy, security, transaction standards |
| Topic 5: Case Analysis | 17% | - Eligibility verification - Adjudication and resolution - End-to-end billing scenarios |
| Topic 6: Claims and Billing | 14% | - Claim submission, tracking, follow-up - Timely filing rules - Electronic claims, clearinghouses - Denials, appeals, corrections |
| Topic 7: Types of Insurance | 21% | - Managed care plans - TRICARE/CHAMPUS, Workers' compensation - Third-party liability - Medicare, Medigap, Medicaid - Commercial payers |
AAPC Certified Professional Biller (CPB) Sample Questions:
1. What does it mean by dis?
A) separation
B) combination
2. contra
A) against, opposite
B) skull
C) blue
D) cold
3. Blue Cross Blue Shield Association (BCBSA) is an association of independent Blue Cross Blue Shield plans.
A) TRUE
B) FALSE
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. What does it mean by cyan?
A) blue
B) yellow
C) green
D) red
Solutions:
| Question # 1 Answer: A | Question # 2 Answer: A | Question # 3 Answer: A | Question # 4 Answer: A | Question # 5 Answer: A |
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