Taking the COC^® exam

With more and more 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.

Outpatient coders report procedures, services, equipment, and supplies provided to patients on behalf of both the physician and the outpatient facility.

After passing the COC exam, employers will recognize 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

• Dialysis Services

• Outpatient Radiology Departments

• Ambulatory Surgery Centers

Who should take the COC exam?

After you’ve trained with AAPC to become a medical coder — or if you have substantial medical coding experience — you should register for the COC exam.

Passing the COC exam elevates your earning potential. As this certification requires expertise in multiple payment systems, COCs are well compensated, earning an average salary of $62,846 per year, which makes the COC one of the highest paid core credentials. If you're thinking about becoming a certified outpatient coder, you can learn more about COC salaries in your area with our salary calculator.

What to expect on exam day

The exam has a total of 100 questions with a minimum of 70 to be answered in four hours. People often wonder if the COC exam is hard. We'll say this: If you have taken the training course, studied, and are familiar with your CPT^®, ICD-10-CM, and HCPCS Level II code books, the test will be demanding, but not difficult.

Here's a quick overview of what you can expect:

Before you begin the test, take a moment and breathe. You have prepared for this. You have your code books by your side and you know how to use them. This is your opportunity to demonstrate your coding expertise.

You'll have four hours to finish the exam, giving you approximately 2.4 minutes to answer each of the 100 multiple-choice questions. You can save time by reading the answer choices before reading each question and by saving the more difficult questions for last. It’s important to answer every question, even if you aren’t sure. Your best guess is better than no answer at all.

The questions assess several areas of knowledge, most of which are presented as coding scenarios to test application of CPT^® procedure codes, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes. The end of the exam has 10 cases that test the ability to read and accurately code a medical record.

You will be able to reference approved medical code books during the exam — the AMA's CPT^® Professional Edition, as well as your choice of ICD-10-CM and HCPCS Level II code books. To be clear, these are the only code books you are allowed to use.

Passing grades

An overall score of 70% or higher is required to pass the certification exam. For a passing score of 70%, you must get at least 70 questions correct. If you incorrectly answer more than 30 questions, you will not pass. If you don’t pass, you will be notified of the categories/areas of study with sub-scores of 65% or less to help you prepare for retesting.

All AAPC certification exams exclusively measure proficiencies relating to the one credential named in the exam. To earn additional medical coding credentials, you will be required to pass additional certification exams.

Your results will be shared with you online in your My AAPC Account Dashboard under My Exams. You can expect the results within 7-10 business days after taking the exam. Once you have passed, your certificate will be sent to you in the mail.

Breakdown of the 100-question COC exam

Passing the COC exam requires you to correctly answer a minimum of 70 questions from the domains below. The exam will rely on a level of understanding that enables you to identify the domain.

Medical terminology (7 questions)
These questions will assess your knowledge of medical terminology for all systems in the human body.

Anatomy (7 questions)
These questions will assess your knowledge of anatomy for all systems in the human body.

Coding guidelines (3 questions)
This section will address the ICD-10-CM Official Guidelines for Coding and Reporting, CPT® coding guidelines and parenthetical notes, and modifier use.

Payment methodologies (13 questions)
This section will test your knowledge of payment methodologies which pertain to services covered under Medicare Parts A, B, C, and D; Medicare as secondary payer; OPPS and IPPS payment methodologies; and UB-04 and CMS-1500 claim form completion requirements.

Compliance (3 questions)
This section will address NCDs/LCDs, HIPAA, and ABNs.

ICD-10-CM (15 questions)
This area will test your proficiency in diagnosis coding within all the chapters of ICD-10-CM, as well as thorough knowledge of the ICD-10-CM Official Guidelines for Coding and Reporting. Additionally, diagnosis questions will appear in other sections of the exam from the CPT® categories.

HCPCS Level II (7 questions)
This section will test your knowledge on HCPCS Level II coding and includes questions focusing on modifiers, supplies, medications, and professional services for Medicare patients.

CPT^® (13 questions)
This section will test your knowledge of CPT® coding for evaluation and management, surgery, radiology, pathology/laboratory, and medicine procedures and services.

Surgery and modifiers (22 questions)
This part of the exam will test your proficiency related to procedures approved for outpatient hospital and ASC facilities.

Cases (10 cases, 1 question each)
Each case will test your ability to accurately code medical record documentation using CPT®, ICD-10-CM, and HCPCS Level II codes.