AAPC's credential validating expertise in coding outpatient hospital and facility services — distinct from physician-office coding (CPC) because outpatient facility coding follows its own reimbursement methodology (the Outpatient Prospective Payment System and Ambulatory Payment Classifications) and involves different documentation and coding conventions than physician professional-fee coding.
Who it's for
Medical coders working in or aiming to work in hospital outpatient departments, ambulatory surgery centers, and other outpatient facility settings. It's a common next credential for coders who already hold a CPC (physician-office coding credential) and want to expand into facility-side coding, as well as for coders entering the field directly into an outpatient hospital setting.
What's covered
- CPT & HCPCS Coding for Outpatient Procedures (35%) — accurately assigning CPT and HCPCS Level II codes for outpatient procedures, surgeries, and ancillary services
- ICD-10-CM Diagnosis Coding (25%) — assigning diagnosis codes to support medical necessity and accurately reflect the patient's condition
- Outpatient Facility Billing & Reimbursement (20%) — the Outpatient Prospective Payment System (OPPS), Ambulatory Payment Classifications (APCs), and outpatient-specific billing rules like modifier usage and National Correct Coding Initiative (NCCI) edits
- Medical Terminology, Anatomy & Compliance (20%) — foundational medical terminology and anatomy needed to code accurately, plus fraud/abuse and regulatory compliance concepts specific to outpatient billing
What to expect
The COC exam is a multiple-choice exam testing both direct coding knowledge (assigning correct CPT/HCPCS/ICD-10-CM codes to described scenarios) and the specific facility-side reimbursement rules that differ from physician-office coding — most notably the APC/OPPS payment methodology, which has no direct equivalent on the physician-fee side.
How to prepare
Candidates coming from a CPC (physician-office) coding background typically find the CPT/HCPCS and ICD-10-CM code-assignment content familiar, but need focused review of outpatient-facility-specific reimbursement rules (APCs, OPPS status indicators, facility-specific modifier usage) that don't have a direct parallel in physician-office billing. Candidates newer to coding overall benefit from building strong medical terminology and anatomy fluency first, since accurate code assignment depends on correctly interpreting clinical documentation.
Certification details
- Certifying body: AAPC.
- Eligibility: AAPC recommends coding experience or completion of a coding training program, though there is no strict experience prerequisite to sit the exam; AAPC membership is required to maintain certification.
- Exam format: Multiple-choice exam covering CPT/HCPCS coding, ICD-10-CM diagnosis coding, outpatient facility billing/reimbursement, and medical terminology/compliance.
- Renewal: Requires ongoing continuing education units (CEUs) and active AAPC membership to maintain certification.