Timed 105-Question Simulation Strategy

Practice the Real Exam Load

The CCA exam has 105 total questions in 2 hours. Ninety questions are scored and 15 are pretest, but candidates do not know which are which. There is no penalty for guessing, so every item should receive an answer.

A full simulation should use the same load: 105 questions, 120 minutes, mixed domains, and access to the same required code books you plan to use on test day. For exams delivered on or after 2026-05-01, AHIMA scheduling instructions say CCA candidates can navigate back and forth. Follow your current ATT and AHIMA instructions.

Pacing Benchmarks

These are checkpoints, not rigid rules. Coding scenarios may take longer than privacy or technology items. The goal is to avoid spending six minutes on one question while easier points remain unanswered.

First Pass Strategy

Answer straightforward questions immediately. For longer coding, reimbursement, or record-analysis items, identify the setting, required code set, documentation fact, and decision being tested. If a question remains uncertain, choose the best current answer, flag it if navigation is available, and move on.

Do not use the code book for every item. Use it when the question requires a guideline, convention, sequencing detail, code range, modifier detail, or table lookup. For conceptual questions about privacy, CAC validation, claim forms, or ethical queries, answer from rule knowledge.

Review Pass Strategy

In the final 10 minutes, review flagged questions first. Change an answer only when you find a concrete reason: a guideline, missed word, wrong setting, unsupported code, or privacy rule. Do not change answers because of anxiety alone.

After the simulation, score by domain and by error type. Track time lost to codebook searching, overreading, weak reimbursement concepts, missed documentation details, and distractor selection. That score report becomes the next remediation plan.