COC Study Guide 2026
Everything you need to pass the COC exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.
COC exam key facts
- The COC exam has 100 multiple-choice questions and is open book, allowing approved CPT, ICD-10-CM and HCPCS Level II code books. Source
- Candidates have four hours in one sitting to complete the COC exam, about 2.4 minutes per question. Source
- Passing the COC exam requires an overall score of 70%, which means at least 70 of the 100 questions answered correctly. Source
- The AAPC Certified Outpatient Coder (COC) exam costs $425 for a one-attempt exam voucher. Source
- COC candidates can buy a two-attempt voucher to cover a retake, and anyone who fails is told which areas they scored 65% or less on to help them prepare for retesting. Source
- An AAPC COC exam voucher is non-refundable and must be used within one year of the purchase date. Source
📋 COC Exam Format at a Glance
📚 COC Topics to Study (24)
✍️ Sample COC Questions & Answers
1. Modifier -KX is used in Medicare billing to indicate:
Modifier -KX attests that the specific coverage criteria for the billed item or service have been met and that the required documentation is on file.
2. Under the OIG Work Plan, which of the following would be a common audit target for outpatient coding?
The OIG routinely targets providers who bill a disproportionately high frequency of the highest-level E/M codes, which may indicate upcoding.
3. Which modifier is appended to a CPT code to indicate that a procedure was performed on the right side of the body?
Modifier -RT (Right Side) is used to indicate a procedure was performed on the right side of the body.
4. A myocardial infarction (MI) occurs when:
An MI occurs when a coronary artery is blocked (usually by a thrombus), cutting off blood supply to a region of myocardium, causing ischemia and ultimately tissue necrosis.
5. What does the STARK Law (Physician Self-Referral Law) prohibit?
The Stark Law prohibits physicians from referring Medicare/Medicaid patients to entities in which the physician or an immediate family member has a financial relationship, for designated health services.
6. The rotator cuff of the shoulder consists of which four muscles?
The rotator cuff is formed by four muscles — supraspinatus, infraspinatus, teres minor, and subscapularis — collectively stabilizing the glenohumeral joint.
🎯 Free COC Practice Tests
📖 COC Guides & Articles
What Practice Test Geeks adds beyond an AI chat for COC
An AI chatbot can quiz you, but it can't reproduce the exam conditions or keep your record. Here you get:
- A timed, full-length COC mock exam — 100 questions in 240 minutes with a 70% pass mark, modeled on the official exam's question count and time limit, followed by a score report broken down by exam domain.
- A fixed COC question bank: the same test every attempt, so your score is comparable from one try to the next instead of changing with every regenerated quiz.
- Progress saved on your device: completed tests, scores and missed questions stay in My Progress, so you can retake only what you got wrong.
- A printable COC cheat sheet you can print or save as a PDF.
- COC flashcards built from the same question bank.
- Free COC practice tests with the correct answer shown after each question.
How this page was made: written with AI tools and published by Nathan Beja, founder of Practice Test Geeks, who is responsible for its content. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy
Sources & references
Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy
- aapc.com — Renewal, score validity, test delivery, fees, exam format, passing score, retake fee, retake policy, score release, time limit · verified Oct 2026