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AAPC Certified Professional Biller (CPB) : CPB Exam

CPB Exam Questions
  • Exam Code: CPB
  • Exam Name: Certified Professional Biller (CPB)
  • Updated: Aug 17, 2026
  • Q & A: 245 Questions and Answers
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AAPC CPB Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Billing Compliance and Regulations10-15%- Stark Law and Anti-Kickback Statute basics
- Appeal and denial management
- Documentation compliance
- HIPAA privacy and security requirements
- Fraud, waste, and abuse prevention
Topic 2: Insurance and Reimbursement20-25%- Fee schedules and reimbursement methodologies
- Government payers (Medicare, Medicaid, TRICARE)
- Claims submission and processing
- Commercial insurance policies
- Coordination of benefits
- Workers' compensation and no-fault billing
Topic 3: Practice Management10-15%- Patient responsibility calculations
- Insurance verification processes
- Patient registration and demographics
- Accounts receivable management
- Collections and payment posting
Topic 4: CPT Coding20-25%- Category II and III codes
- Evaluation and Management (E/M) codes
- CPT code categories and structure
- Modifiers and their appropriate use
- Surgical procedure codes
Topic 5: ICD-10-CM Diagnosis Coding15-20%- ICD-10-CM structure and conventions
- Code accuracy and specificity
- Secondary diagnosis coding
- Principal diagnosis selection
- Chapter-specific guidelines
Topic 6: Healthcare Billing Fundamentals15-20%- Revenue cycle overview
- Healthcare documentation principles
- Anatomy and physiology for billers
- Medical terminology basics

AAPC Certified Professional Biller (CPB) Sample Questions:

1. CMS

A) Centers of Medicare and Medicaid Services
B) Insurance claim used by noninstitutional providers and supplier to bill payers
C) UB04 Claim used by institutional and other selected providers to bill payers
D) Clinical nurse specialist


2. HCPCS stands for Healthcare Common Procedure Coding System.

A) FALSE
B) TRUE


3. FCA

A) False Claims Act
B) Federal Employee Health Benefit Program
C) Fair Debt Collection Practices Act
D) Federal Employment Compensation Act


4. abdomin

A) abdomen
B) extremities, top
C) toward


5. Allowable Charge

A) See limiting charge; maximum fee a physician may charge.
B) Adopted by Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries; expanded original DRG system (based on intensity of resources) to add two subclasses to each DRG that adjusts Medicare inpatient hospital reimbursement rates for of mortality (ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme.
C) The Maximum amount the payer will reimburse for each procedure or service, according to the patients policy.
D) DRG system adapted for use by thirdparty payers to reimburse hospitals for inpatient care provided to nonMedicare beneficiaries (e.g. Blue Cross Blue Shield, commercial health plans, TRICARE); DRG assignment is based on intensity of resources.


Solutions:

Question # 1
Answer: A
Question # 2
Answer: B
Question # 3
Answer: A
Question # 4
Answer: A
Question # 5
Answer: A

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