FREE CPC-H Study Guide 2026: How to Pass the COC (Formerly CPC-H) Exam
If you are searching for CPC-H study guide 2026, the current credential name you need is COC (Certified Outpatient Coder) from AAPC. Employers and candidates still use “CPC-H” in job searches, but the credential transitioned to COC and now focuses on outpatient facility coding in hospital and ambulatory settings.
The exam is open-book, but that does not make it easy. Success depends on code-set navigation speed, outpatient reimbursement logic, compliance judgment, and the ability to apply coding rules accurately under strict time limits.
This guide gives you a full 2026 strategy: exam format, content priorities, open-book setup, 10-week timeline, and career salary context.
Exam Format & Structure
| Component | Details |
|---|---|
| Total Questions | 100 multiple-choice |
| Time Limit | 4 hours |
| Passing Score | 70% |
| Pass Rate | AAPC does not publish a public annual pass rate |
| Cost | $499 package includes two exam attempts (AAPC) |
| Testing Format | Open-book, proctored testing (online and in-person options) |
| Allowed Code Books | CPT, ICD-10-CM, HCPCS Level II |
Why CPC-H/COC Is Different From Physician Coding Exams
COC emphasizes outpatient facility coding and reimbursement integrity. That means you are not just selecting codes; you are evaluating whether documentation, charge capture, and outpatient payment logic align correctly.
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COC (CPC-H) Domain Breakdown for 2026 Study Planning
AAPC’s public help resources focus on exam structure and eligibility, so candidates should use a practical domain model when studying:
| Domain Cluster | What You Must Be Able to Do |
|---|---|
| Outpatient ICD-10-CM Coding | Sequence diagnosis codes accurately for outpatient encounters |
| CPT/HCPCS Facility Coding | Assign procedure/service codes with correct outpatient context |
| Regulatory & Compliance Controls | Apply coding guidance and documentation standards correctly |
| Outpatient Reimbursement Logic | Understand APC/OPPS-related decision impacts and edits |
| Modifier and Edit Management | Resolve NCCI/OCE-style edits and modifier use scenarios |
| Audit Readiness and Quality | Detect coding variance, defend code selection, and support correction workflows |
Priority Skill Areas That Drive Scores
- High-speed codebook navigation under timed conditions
- Outpatient encounter interpretation from real-world documentation
- Edit and modifier judgment for claim integrity
- Compliance-safe decision making when options are close
Open-Book Reality
Open-book candidates who pass usually do three things well:
- Tab code books by high-frequency outpatient sections
- Practice lookup speed every week under time limits
- Use repeatable coding workflows instead of ad hoc guessing
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10-Week CPC-H (COC) Study Timeline
This schedule fits candidates studying 8-12 hours per week.
| Week | Focus | Target Outcome |
|---|---|---|
| 1 | Exam setup + baseline assessment | Identify weakest content clusters |
| 2 | ICD-10-CM outpatient sequencing | Improve diagnosis coding consistency |
| 3 | CPT outpatient procedure coding | Strengthen procedural code selection |
| 4 | HCPCS + modifiers | Improve modifier accuracy under scenarios |
| 5 | Reimbursement logic and edits | Understand APC/OCE/NCCI implications |
| 6 | Compliance and documentation rules | Reduce risky answer selections |
| 7 | Audit and quality controls | Build variance detection skills |
| 8 | Mixed timed blocks | Raise speed and endurance |
| 9 | Full-length simulation | 4-hour pacing calibration |
| 10 | Weak-area remediation + final review | Push score stability before exam day |
Weekly Output Benchmarks
- 120-150 targeted questions per week
- Error log by category (coding, modifier, compliance, timing)
- One timed mini-block (40-60 questions) each week from Week 4 onward
Final Two-Week Focus
- Rework prior misses instead of only taking new questions
- Tighten modifier/edit rules where errors repeat
- Practice end-of-exam fatigue with longer timed sessions
Test-Taking Strategies for the COC/CPC-H Exam
1) Pacing Math First
100 questions in 240 minutes gives about 2.4 minutes per question. Some cases will require more time, so bank quick points early.
2) Use a Three-Step Coding Decision Process
For each scenario:
- Identify the clinical intent and setting
- Select the best diagnosis and service coding pathway
- Validate modifiers and edit implications before finalizing
3) Flag and Return to Long Cases
Do not spend 6-8 minutes on one difficult scenario in the first half of the exam. Flag it and preserve score momentum.
4) Prioritize Compliance-Safe Choices
When two answers look possible, select the one most consistent with outpatient coding guidance and documentation standards.
5) Train Open-Book Navigation Like a Performance Skill
Fast lookups are a scoring advantage. Build and test your tab system before exam week.
Career & Salary Information for CPC-H / COC Candidates
COC can support advancement into outpatient facility coding and revenue integrity functions.
| Career Path | Common Next Roles |
|---|---|
| Facility coding track | Outpatient Coder, Senior Outpatient Coder |
| Quality and integrity track | Coding Quality Analyst, Denial Prevention Specialist |
| Audit progression | Outpatient Auditor, Compliance Coding Specialist |
Compensation and Market Signals
- AAPC’s COC program materials cite average compensation around $62,846 for COC-certified professionals (salary survey reference in AAPC materials).
- U.S. BLS data for medical records specialists shows a national median in the high-$40,000 range, with stronger salaries in specialty, audit, and complex facility environments.
- The same occupation group is projected to grow about 8% over the 2024-2034 period, indicating continued demand for coding and data-quality skill sets.
Why COC Matters in 2026
Outpatient reimbursement complexity and edit risk are increasing. Employers need coders who can code accurately, protect claim quality, and support compliance outcomes. COC is directly aligned with those needs.
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