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Certified Outpatient Coder (COC) 

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EXAM FORMAT (150 multiple choice questions)   

• Medical Terminology (10) 

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• Anatomy (10)

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• Coding Guidelines (5)​

  • ICD-10-CM Official Guidelines for Coding and Reporting

  • CPT® coding guidelines and parenthetical notes

  • Modifier use

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• Payment Methodologies (20)

  • ​Services covered by Medicare Parts A, B, C, and D

  • Medicare as a secondary payer

  • Requirements for completion of UB04 claim form

  • Requirements for completion of CMS 1500 claim form

  • OPPS Payment Methodology

  • APCs

  • Revenue codes

  • Status Indicators

  • Payment Indicators

  • Condition codes

  • Calculation of proper payments (excerpts from Addendum B and Addendum AA are provided on the exam)

  • IPPS Payment Methodology

  • Elements needed to determine MS-DRGs

  • Code sets required for inpatient claims

  • Reimbursement for teaching hospital setting

  • Change masters

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• Compliance (5) 

  • NCDs/LCDs

  • HIPAA

  • ABNs

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• ICD-10-CM (30

  • ICD-10-CM Official Guidelines for Coding and Reporting

  • Diagnoses for all the chapters included in ICD-10-CM

  • Diagnosis questions will also appear in other sections of the exam from the CPT® categories

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• CPT® (20)

  • 20 questions

  • Evaluation and Management

  • Emergency Department

  • Outpatient Clinics

  • Observation

  • Critical Care

  • Surgery

  • Procedures approved for outpatient hospital facilities

  • Procedures approved for ASC facilities

  • Radiology

  • Diagnostic Radiology

  • Diagnostic Ultrasound

  • Radiologic Guidance

  • Mammography

  • Bone and Joint Studies

  • Radiation Oncology

  • Nuclear Medicine

  • Laboratory/Pathology

  • Organ and Disease Panels

  • Drug Testing

  • Therapeutic Drug Assays

  • Evocation/Supression Testing

  • Consultations

  • Urinalysis

  • Molecular Pathology

  • MAAA

  • Chemistry

  • Hematology and Coagulation

  • Immunology

  • Transfusions

  • Microbiology

  • Anatomic Pathology

  • Cytopathology

  • Cytogenetic Studies

  • Surgical Pathology

  • In vivo and Reproductive

  • Medicine

  • Immunizations

  • Psychiatry

  • Dialysis

  • Gastroenterology

  • Ophthalmology

  • Otorhinolaryngology

  • Cardiovascular

  • Noninvasive Vascular Studies

  • Pulmonary

  • Neurology

  • Central Nervous System Assessments

  • Hydration

  • Therapeutic and Diagnostic Administration

  • Chemotherapy Administration

  • Physical Medicine and Rehabilitation

  • Patient Education and Training

  • Non-Face-to-Face Nonphysician Services

  • Moderate Sedation

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• HCPCS Level II Coding (10) 

  • Modifiers

  • Supplies

  • Medications

  • Procedures performed on Medicare patients

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• HCPCS Level II Coding (40) 

  • Procedures approved for outpatient hospital facilities

  • Procedures approved for ASC facilities

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