COC (Formerly CPC-H)
Certified Outpatient Coder (COC™)
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ExploreAbout this exam
The Certified Outpatient Coder (COC™) - the credential formerly known as CPC-H - is the outpatient hospital and facility coding certification offered by AAPC. It validates that a coder can assign ICD-10-CM diagnosis codes, CPT® procedure codes, and HCPCS Level II supply codes accurately for outpatient encounters such as same-day surgery, endoscopy, emergency department visits, observation services, and hospital-based clinic diagnostics and therapeutics, in compliance with official guidelines and payer requirements.
The exam blueprint is split evenly across four areas: core outpatient coding knowledge; outpatient documentation and compliance, including medical necessity, NCCI edits, and spotting incomplete documentation that affects reimbursement; facility-based outpatient services; and revenue cycle and reimbursement, covering revenue code linkage, Ambulatory Payment Classification (APC) assignment, and denial prevention.
The credential suits new coders launching a hospital or facility coding career, experienced but uncertified coders who want to validate their skills, certified coders expanding from physician-office work into facility coding, and healthcare professionals moving into outpatient coding, auditing, or compliance. Preparation options include self-paced and virtual instructor-led COC prep courses, study guides, practice exams, and exam review. Maintenance requires an active AAPC membership and 36 continuing education units every two years.
What you'll study
About COC (Formerly CPC-H) preparation
How is the COC exam delivered?
You choose between a live remote proctored exam taken online at home and an in-person exam at a testing center. Purchasing an exam voucher lets you view the available dates and times. Both delivery options test the same four outpatient domains, so choose based on whether your home environment supports a quiet, camera-monitored session.
How does COC content differ from CPC content?
AAPC describes the CPC preparation course as teaching physician office coding, while the COC preparation course teaches coding for an outpatient hospital and facility setting. COC adds facility-specific material: revenue codes, APC assignment, NCCI edits, compliance, and encounters such as same-day surgery, emergency visits, and observation services.
What does the exam cost, and what does prep cost?
An exam voucher starts at $425, and scheduling through the voucher shows current dates and times. COC preparation training, offered in self-paced and virtual instructor-led formats, starts at $2,195. Because both figures are listed as starting prices, confirm the current amount for your chosen format and date before you budget.
Do I need coding experience before sitting for the COC?
AAPC asks for high-level knowledge of medical terminology, anatomy, and pathophysiology, plus understanding of proper application of CPT® procedure codes, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes. Completing the COC online preparation course waives 80 hours of coding education, which waives one year of work experience toward apprentice status removal.
How many questions are on the exam, and how long is it?
The COC materials reviewed here do not publish an item count or time limit, so those values are unconfirmed. Check the current figures on AAPC's certification page or when you schedule, and do not rely on numbers printed in older CPC-H prep books, since exam specifications are revised over time.
What is the passing score, and what happens if I fail?
Neither a passing score nor a retake policy appears in the COC material reviewed here, so treat any number you hear as unverified. Contact AAPC directly before you sit so you know the score you need and the options available if you do not pass on the first attempt.
How do I keep the COC credential once I pass?
You must maintain your AAPC annual membership and earn 36 continuing education units every two years. Note that credit is not awarded for educational activities completed before you obtained certification, so plan your CEU budget starting from your certification date rather than counting earlier coursework.
What study order works best?
Build foundations first: ICD-10-CM conventions and guidelines, then CPT® and HCPCS Level II code application, then the facility layer - revenue codes, APC assignment, and NCCI edits. Finish with documentation and compliance scenarios and full-length timed practice exams so pacing and code book navigation are automatic on test day.
What are the most common ways candidates lose points?
Coding every case like a physician-office coder instead of a facility coder, ignoring documentation that fails medical necessity, missing the revenue code and APC pairing, and never practicing with actual code books under time pressure. Facility scenarios reward knowing what the hospital bills, not only what the provider performed.