With some physicians choosing to join hospital groups over private practices, the need for certified outpatient coders continues to escalate, making COC certification a smart career move. A COC certification demonstrates your mastery of outpatient hospital coding, including working knowledge of ambulatory payment classifications (APCs), payment status indicators, and Medicare severity-diagnosis-related groups (MS-DRGs). Coders who earn their COC credential go on to report outpatient services in a variety of settings, such as:
Hospital emergency departments
Outpatient hospital clinics
Outpatient therapy departments
Outpatient cancer centers
Outpatient radiology departments
Ambulatory surgery centers
100 multiple-choice questions
Online or in-person options
AAPC offers online and in-person proctored exams. Choose to take the exam at home in a quiet, private location or through your local chapter or a licensed instructor. Learn more about the online proctored exam and how to prepare for the current exam.
In-person and online exams are administered in one sitting, with four hours to complete the exam.
Equipment required for online exam
A reliable internet connection and an external webcam that can be positioned to show your face, hands, keyboard, and the area around the keyboard (about 10 inches) are required.
A high-level knowledge of medical terminology, anatomy, and pathophysiology, along with understanding of the proper application of CPT® procedure codes, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes.
Not ready yet? We recommend taking our COC preparation course.
Approved code books
AMA's CPT® Professional Edition (current year)
ICD-10-CM (current year), any publisher
HCPCS Level II (current year), any publisher
Note: Code sets are updated annually, so it’s essential to use the current calendar year's code books when taking the COC certification exam.
Any officially published updates (errata) for the above code books may also be used.
Maintaining your certification
To maintain your credential, you must maintain your AAPC annual membership, and earn 36 continuing education units (CEUs) every two years.
One attempt for $399 or $499 for two attempts. Of note:
80% of AAPC students pass on the first attempt.
Students who train with AAPC are three times more likely to pass the certification exam.
The COC exam contains 100 multiple-choice questions (proctored). The exam consists of questions regarding the correct application of CPT®, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes used for coding and billing outpatient facility/hospital and freestanding ASC services to insurance companies.
Whether you take the exam online or in-person, you must complete the COC exam within four hours and answer 70% of the questions correctly to pass.