Credential type: certification examination · verified on the issuer's site September 20, 2026 issuer page
The Certified Outpatient Coder (COC) exam, administered by AAPC, tests knowledge across nine domains: facility coding concepts, evaluation and management, outpatient surgery and procedures, radiology, pathology and laboratory, medicine and ancillary services, HCPCS Level II, ICD-10-CM, and revenue cycle management. It consists of 100 multiple-choice questions in a linear format, lasts 340 minutes, and requires a 70 % score to pass. The exam costs $399 for non-members and $299 for members, and the certification is valid for two years, with renewal required.
Medical coders, billing specialists, health information technicians, and clinicians who regularly code outpatient services should pursue the COC credential to validate their expertise in facility and professional coding, E/M, and revenue cycle processes.
Start with the official AAPC COC study guide, then complete practice exams on the AAPC website to gauge timing. Focus on the updated E/M guidelines and HCPCS Level II add-on codes. Review coding tables for radiology, pathology, and surgery. Schedule daily timed drills, track weak areas, and join an AAPC study group for discussion and clarification.
Facility Coding Concepts covers the structure of CPT, HCPCS, and ICD‑10‑CM codes used in outpatient settings, including modifiers, bundling rules, and payer-specific requirements. Mastery ensures accurate claim submission and reimbursement for facility services.
Evaluation and Management focuses on selecting the appropriate E/M level based on history, exam, and medical decision making, as well as time‑based reporting and the use of add‑on codes such as G2211.
Outpatient Surgery and Procedures addresses coding for surgical services performed in ambulatory settings, including CPT surgery sections, global periods, and appropriate use of modifiers for multiple procedures accurately.
Radiology examines imaging service codes, appropriate use of modifiers, and distinctions between diagnostic and interventional radiology procedures, including modality-specific guidelines and documentation requirements, to ensure correct billing and compliance.
Pathology and Laboratory covers coding for clinical lab tests, pathology services, and the application of CPT and HCPCS codes for specimen collection, analysis, and reporting, including molecular and genetic testing considerations.
Medicine and Ancillary Services includes coding for office visits, preventive services, and ancillary procedures such as physical therapy, ensuring proper use of CPT and HCPCS Level II codes throughout the care continuum.
HCPCS Level II focuses on non‑physician services, medical supplies, and equipment codes, including the correct application of add‑on and modifier codes for Medicare billing, as well as understanding regional carrier guidelines.
ICD-10-CM addresses diagnosis coding conventions, chapter organization, and the selection of accurate codes to support the services reported in the other domains, including laterality and external cause coding considerations.
Revenue Cycle Management reviews the end‑to‑end process from claim creation to payment, emphasizing documentation, compliance, denial management, and the role of coding accuracy in financial outcomes and revenue integrity.
Arrive early, bring a valid ID and your confirmation email, and ensure a quiet environment. Allocate roughly three minutes per question, flag uncertain items, and review flagged questions if time permits before submitting.
The COC exam contains 100 multiple‑choice questions presented in a linear format. All questions must be answered in the allotted 340‑minute window, and each correct answer contributes toward the 70 % passing threshold.
The exam requires a minimum score of 70 % to pass. With 100 questions, you need to answer at least 70 correctly. Scores are calculated automatically at the end of the testing session.
The testing session lasts 340 minutes, which is just over five and a half hours. This time includes all 100 questions and allows for review of flagged items before final submission.
If you do not achieve the passing score, AAPC permits a retake after a waiting period. You must pay the exam fee again and may use the same study resources to improve your performance.
Verified 2026-09-02
This editorial was compiled by extracting key facts from AAPC’s official COC exam guide, certification page, and study documentation, then synthesizing concise guidance for candidates.