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AAPC Certified Professional Biller (CPB) Examination

AAPC CPB Practice Test

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Questions updated at Sep 5, 2026, 3:58 AM CDT

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Today's 10 AAPC CPB questions

Use this AAPC CPB practice test to review AAPC Certified Professional Biller CPB Examination. Questions rotate daily and each answer links back to the source used to write it.

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Question 1 of 10
Objective AAPC CPB blueprint — HCPCS Level II and POS Coding

An ambulance claim reports A0429 for BLS emergency transport but omits the separately reportable mileage code. Which HCPCS Level II code is commonly used for ground mileage?

Concept tested:
Source:CMS — HCPCS Quarterly Update
Question 2 of 10
Objective AAPC CPB blueprint — electronic claims and clean claims Claims and billing

Which transaction is used for eligibility and benefit inquiry/response?

Concept tested:
Question 3 of 10
Objective AAPC CPB blueprint — LCDs and NCDs Billing regulations

A MAC’s LCD conflicts with an applicable national coverage determination. Which policy controls?

Concept tested:
Question 4 of 10
Objective AAPC CPB blueprint — CMS-1500 completion Billing regulations

Which statement about the CMS-1500 is MOST accurate?

Concept tested:
Question 5 of 10
Objective AAPC CPB blueprint — provider credentialing and enrollment Reimbursement and collections

A new physician expects to bill Medicare next month but has not completed enrollment. Which CMS system is used to manage Medicare provider enrollment electronically?

Concept tested:
Question 6 of 10
Objective AAPC CPB blueprint — NCCI edits Billing regulations

A coder uses modifier 59 to bypass an NCCI edit but the note shows the second service was integral to the first at the same site and encounter. What should the biller do?

Concept tested:
Question 7 of 10
Objective AAPC CPB blueprint — LCD/NCD case analysis Case analysis

Coverage excerpt — NCD: coverage requires documented symptom A and failed conservative treatment B. The record shows symptom A but no evidence of treatment B. What should the biller conclude before claim submission?

Concept tested:
Question 8 of 10
Objective AAPC CPB blueprint — HIPAA security HIPAA and compliance

A practice updates its HIPAA Security Rule policies. How long must required Security Rule documentation generally be retained?

Concept tested:
Question 9 of 10
Objective AAPC CPB blueprint — billing compliance HIPAA and compliance

A coder reports a service that was never performed because the physician says the payer 'usually pays it.' What is the key compliance issue?

Concept tested:
Question 10 of 10
Objective AAPC CPB blueprint — appeal letter case analysis Case analysis

Appeal file excerpt — Medicare RA received May 1; first-level redetermination deadline is generally 120 days from receipt. The biller begins preparing the appeal on June 15. What is the key action?

Concept tested:
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The free daily AAPC CPB set includes crawlable question text, answer choices, correct answer labels, objective mapping, and source links. Only the first SEO card includes answer explanations and any extra learning features. Pro-only bank questions stay locked; this section mirrors only the 10 free daily questions already shown on this page.

Question 1 An ambulance claim reports A0429 for BLS emergency transport but omits the separately reportable mileage code. Which HCPCS Level II code is commonly used for ground mileage?

Answer choices

  1. A. A0429 for mileage only, with no transport service.
  2. B. G0447 for ambulance mileage after an emergency transport.
  3. C. A0425 for ground mileage, per statute mile.
  4. D. Q2025 for each mile traveled by an ambulance.

Correct answer

A0425 for ground mileage, per statute mile.

HCPCS Level II separates ambulance transport from ground mileage; A0425 is the mileage code. This corrects a major error in the attached bank, which treated A0429 as mileage.

Wrong-answer review

  • A. A0429 for mileage only, with no transport service.: Incorrect. HCPCS Level II code selection must match the official CMS code descriptor and documented service. The option does not report the service or mileage component correctly.
  • B. G0447 for ambulance mileage after an emergency transport.: Incorrect. HCPCS Level II code selection must match the official CMS code descriptor and documented service. The option does not report the service or mileage component correctly.
  • D. Q2025 for each mile traveled by an ambulance.: Incorrect. HCPCS Level II code selection must match the official CMS code descriptor and documented service. The option does not report the service or mileage component correctly.

Extra learning features

Why candidates miss this

The tempting wrong answer is: “A0429 for mileage only, with no transport service.” The mistake is treating a familiar billing shortcut as the controlling rule. A0425 is commonly used for separately reportable ground ambulance mileage; A0429 describes BLS emergency transport, not mileage-only billing. Decisive clue: A0429 transport + missing ground mileage. On the exam, identify the payer/policy/workflow first, then choose the action supported by the documented facts. Likely wrong answer: A0429 for mileage only, with no transport service. Review focus: CMS — HCPCS Quarterly Update

Why this matters

HCPCS Level II and place-of-service errors can change coverage, editing, and payment. Accurate code and setting selection keeps the claim aligned with the service actually furnished.

Objective/domain: Coding

Source: CMS — HCPCS Quarterly Update

Question 2 Which transaction is used for eligibility and benefit inquiry/response?

Answer choices

  1. A. 276/277.
  2. B. 837/835.
  3. C. 270/271.
  4. D. 278/999.

Correct answer

270/271.

Objective/domain: Claims and billing

Source: CMS — Adopted Standards and Operating Rules

Question 3 A MAC’s LCD conflicts with an applicable national coverage determination. Which policy controls?

Answer choices

  1. A. The NCD controls because an LCD cannot contradict a national CMS coverage determination.
  2. B. The LCD controls because local contractors may override national CMS policy, which would treat reimbursement preference as a substitute for the cited Medicare or coding requirement.
  3. C. Whichever policy pays more controls for participating providers.
  4. D. The provider may choose the policy used on each claim.

Correct answer

The NCD controls because an LCD cannot contradict a national CMS coverage determination.

Objective/domain: Billing regulations

Source: CMS — Medicare Coverage Database

Question 4 Which statement about the CMS-1500 is MOST accurate?

Answer choices

  1. A. It is the standard professional paper claim form maintained by NUCC and used by eligible non-institutional providers.
  2. B. It is the institutional hospital claim form commonly called the UB-04, despite leaving the practice unable to show that the reported services satisfy the applicable billing requirements.
  3. C. It is the Medicare appeal form used for a first-level redetermination.
  4. D. It is the electronic 835 remittance advice transaction.

Correct answer

It is the standard professional paper claim form maintained by NUCC and used by eligible non-institutional providers.

Objective/domain: Billing regulations

Source: CMS — Professional Paper Claim Form (CMS-1500)

Question 5 A new physician expects to bill Medicare next month but has not completed enrollment. Which CMS system is used to manage Medicare provider enrollment electronically?

Answer choices

  1. A. NCCI.
  2. B. COBA.
  3. C. PECOS.
  4. D. MUE.

Correct answer

PECOS.

Objective/domain: Reimbursement and collections

Source: CMS — Medicare Provider Enrollment (PECOS)

Question 6 A coder uses modifier 59 to bypass an NCCI edit but the note shows the second service was integral to the first at the same site and encounter. What should the biller do?

Answer choices

  1. A. Keep modifier 59 because a separate line item always supports distinctness.
  2. B. Replace modifier 59 with modifier 25 because every procedure pair allows an E/M modifier.
  3. C. Submit both codes without review because NCCI applies only after payment.
  4. D. Remove the unsupported bypass modifier and correct the claim before submission.

Correct answer

Remove the unsupported bypass modifier and correct the claim before submission.

Objective/domain: Billing regulations

Source: CMS — Medicare NCCI FAQ Library

Question 7 Coverage excerpt — NCD: coverage requires documented symptom A and failed conservative treatment B. The record shows symptom A but no evidence of treatment B. What should the biller conclude before claim submission?

Answer choices

  1. A. The documentation does not yet show that the stated NCD coverage criteria are fully met.
  2. B. The NCD is satisfied because one of two criteria is enough unless the physician disagrees.
  3. C. Add failed treatment B to the claim even though it is not documented.
  4. D. Use modifier 59 to bypass the missing coverage criterion.

Correct answer

The documentation does not yet show that the stated NCD coverage criteria are fully met.

Objective/domain: Case analysis

Source: CMS — Medicare Coverage Database

Question 8 A practice updates its HIPAA Security Rule policies. How long must required Security Rule documentation generally be retained?

Answer choices

  1. A. Six years from the later of creation or the date the document was last in effect.
  2. B. Two years from the date the policy was first drafted.
  3. C. Ten years after every patient named in the policy leaves the practice.
  4. D. Indefinitely, because HIPAA requires permanent retention of all security documentation, which treats an operational convenience as though it automatically creates a HIPAA or compliance exception.

Correct answer

Six years from the later of creation or the date the document was last in effect.

Objective/domain: HIPAA and compliance

Source: HHS OCR — Summary of the HIPAA Security Rule

Question 9 A coder reports a service that was never performed because the physician says the payer 'usually pays it.' What is the key compliance issue?

Answer choices

  1. A. It is acceptable if the code is commonly used by other practices.
  2. B. It is only a HIPAA privacy issue because no medical record was disclosed, despite not applying the specific privacy, security, or fraud-and-abuse principle implicated by the facts.
  3. C. It becomes compliant if the patient does not have a deductible.
  4. D. Billing for a service not rendered can constitute a false claim and must not be submitted.

Correct answer

Billing for a service not rendered can constitute a false claim and must not be submitted.

Objective/domain: HIPAA and compliance

Source: HHS OIG — Fraud & Abuse Laws

Question 10 Appeal file excerpt — Medicare RA received May 1; first-level redetermination deadline is generally 120 days from receipt. The biller begins preparing the appeal on June 15. What is the key action?

Answer choices

  1. A. Wait one year because all Medicare appeals share the claim filing deadline, even though the source document contains the specific fact the biller must use to choose the next action.
  2. B. Send the request directly to federal court as the first appeal level.
  3. C. Change the RA date on the form so the deadline restarts.
  4. D. Submit the written redetermination with required claim information and evidence before the 120-day deadline.

Correct answer

Submit the written redetermination with required claim information and evidence before the 120-day deadline.

Objective/domain: Case analysis

Source: CMS — First Level of Appeal: Redetermination

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