COE Study Guide 2026

Everything you need to pass the COE 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.

📋 COE Exam Format at a Glance

150
Questions
180 min
Time Limit
70%
Passing Score

📚 COE Topics to Study (21)

✍️ Sample COE Questions & Answers

1. Which of the following is an essential feature of a good EHR system for ophthalmic practices?
Comprehensive clinical documentation capabilities specific to ophthalmology

An essential feature of a good EHR system for an ophthalmic practice is its ability to support detailed clinical documentation tailored to ophthalmology. This includes specialized templates for eye exams, visual acuity, intraocular pressure, imaging results, and surgical notes. These specific capabilities are crucial for accurate record-keeping and delivering high-quality, specialized patient care.

2. To safeguard the practice's assets and prevent fraud, a crucial internal control is the segregation of duties. Which of the following scenarios best exemplifies this principle?
One employee is responsible for opening mail and preparing bank deposits, while a different employee posts payments to the practice management system.

Segregation of duties is an internal control designed to prevent fraud and errors by ensuring that no single individual has control over all aspects of a financial transaction. Having one person handle the physical payment (opening mail, preparing deposits) and another handle the recording of that payment (posting to accounts) creates a system of checks and balances.

3. The Net Promoter Score (NPS) measures:
Likelihood of patients recommending the practice to others

NPS surveys patients on how likely they are to recommend the practice on a 0–10 scale, yielding a single loyalty metric.

4. An ophthalmology practice's marketing plan should be reviewed and updated:
At least annually, or when significant changes occur in the competitive environment, payer mix, or practice strategic goals

An annual review—or more frequent review triggered by major market or internal changes—ensures the marketing plan remains relevant, effective, and aligned with current practice objectives.

5. In Lean methodology, 'waste' (muda) in an ophthalmic practice includes all of the following EXCEPT:
Documented clinical protocols

Documented clinical protocols are a form of standardization and quality assurance, not waste; Lean targets non-value-adding activities.

6. Diabetic retinopathy is a significant cause of vision loss. The primary cause of this condition is damage to which of the following eye structures?
Retinal blood vessels

Diabetic retinopathy is a microvascular complication of diabetes caused by chronic high blood sugar levels damaging the small blood vessels within the retina. This damage can lead to leakage of fluid (macular edema) or the growth of abnormal new blood vessels, both of which can severely impair vision.

🎯 Free COE Practice Tests

📖 COE Guides & Articles

Your COE Study Path
1. Learn with Flashcards → 2. Drill Practice Tests → 3. Take the Full Exam Simulation
COE Study Guide 2026 — Exam Format, Topics & Practice Questions