Certified Professional Biller (CPB) Practice Exam AAPC Certification Prep –Questions with Answers 2025

Certified Professional Biller (CPB) Practice
Exam
AAPC Certification Prep –Questions with
Answers 2025




Section 1: Insurance & Reimbursement Basics
What does CMS stand for?
A) Centers for Medicaid and Medicare Services
B) Coding and Medical System
C) Clinical Medical Services
D) Claim Management Standards
Answer: A


What form is used for outpatient medical billing?
A) UB-04
B) CMS-1500
C) ADA-2012
D) NPI
Answer: B

,Which type of insurance is federally funded and serves individuals 65+ or
disabled?
A) Medicaid
B) PPO
C) Medicare
D) TRICARE
Answer: C


Which part of Medicare covers outpatient physician services?
A) Part A
B) Part B
C) Part C
D) Part D
Answer: B


What is the term for the fixed amount paid by a patient at the time of service?
A) Deductible
B) Premium
C) Copayment
D) Coinsurance
Answer: C


Section 2: Coding & Compliance
Which code set is used to report diagnoses?

,A) CPT
B) ICD-10-CM
C) HCPCS
D) NDC
Answer: B


Modifier -25 is used to indicate:
A) A bilateral procedure
B) A significant, separately identifiable E/M service
C) A discontinued procedure
D) A staged procedure
Answer: B


Which organization maintains the CPT code set?
A) CMS
B) WHO
C) AMA
D) AAPC
Answer: C


Upcoding is an example of:
A) Coding efficiency
B) Fraud
C) Best practice

, D) Denial management
Answer: B


Which law protects patient health information (PHI)?
A) COBRA
B) HIPAA
C) HITECH
D) ACA
Answer: B


Section 3: Claims Processing
What does EOB stand for?
A) Evaluation of Benefits
B) Explanation of Benefits
C) End of Billing
D) Enrollment of Benefits
Answer: B


Which section of the CMS-1500 form contains the provider’s NPI?
A) Box 17
B) Box 24
C) Box 33a
D) Box 21
Answer: C