Exam Name: Certified Professional Biller (CPB)
Certification Provider: AAPC
Corresponding Certification: AAPC Certification
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Check Updated on: Sep 13, 2026
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AAPC CPB Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Coding Concepts for Billers | 12% | - Medical necessity - Code validation, modifiers - ICD-10-CM, CPT®, HCPCS Level II |
| Topic 2: Billing Regulations | 13% | - Payer payment policies - CMS-1500, UB-04 completion - ACOs, NCCI, LCDs, NCDs - Incident-to billing, global packages |
| Topic 3: Reimbursement and Collections | 14% | - Accounts receivable management - Payment posting, adjustments - Patient statements, collections - Refunds, payment plans, write-offs |
| Topic 4: Case Analysis | 17% | - End-to-end billing scenarios - Eligibility verification - Adjudication and resolution |
| Topic 5: Claims and Billing | 14% | - Claim submission, tracking, follow-up - Electronic claims, clearinghouses - Denials, appeals, corrections - Timely filing rules |
| Topic 6: HIPAA and Compliance | 9% | - Compliance programs - Medical record retention - Fraud, abuse, False Claims Act - Privacy, security, transaction standards |
| Topic 7: Types of Insurance | 21% | - TRICARE/CHAMPUS, Workers' compensation - Managed care plans - Commercial payers - Third-party liability - Medicare, Medigap, Medicaid |
AAPC Certified Professional Biller (CPB) Sample Questions:
What does it mean by cry?
- A. cold
- B. hot
- C. warm
- D. cool
EMC
- A. Electronic Media Claim
- B. Electronic Medical Record
- C. Exclusive provider organization
- D. Explanation of Benefits
CMS
- A. Insurance claim used by noninstitutional providers and supplier to bill payers
- B. Clinical nurse specialist
- C. UB04 Claim used by institutional and other selected providers to bill payers
- D. Centers of Medicare and Medicaid Services
What is the coding system currently in use to report diagnoses and reasons for encounter?
- A. International Classification of Diseases, 9th revision, clinical modification (ICD9CM)
- B. International Classification of Diseases, 6th revision, clinical modification (ICD6CM)
- C. International Classification of Diseases, 7th revision, clinical modification (ICD7CM)
- D. International Classification of Diseases, 8th revision, clinical modification (ICD8CM)
The medical prefixes "a-" and "an-" mean:
- A. abdomen
- B. away from
- C. no, not
- D. extremities, top
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