Free Certified Outpatient Coder (COC®) exam Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Certified Outpatient Coder (COC®) exam practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1In the term neuritis, what does the suffix -itis indicate?

   1. A. Inflammation
   2. B. Surgical repair
   3. C. Recording
   4. D. A nerve

   Answer: A

   Explanation: The guide states, "Neuritis = Inflammation of a nerve." The suffix describes inflammation; the nerve is the root meaning.

   Reference: 2026 Official Study Guide COC® Certification, sample pages — p. 7, Medical Terminology, Rule #1 example

2. 2When classifying skeletal structures, which one belongs to the axial skeleton?

   1. A. Thoracic cage
   2. B. Femur
   3. C. Humerus
   4. D. Clavicle

   Answer: A

   Explanation: OpenStax states that the axial skeleton "consists of the skull, vertebral column, and thoracic cage." The limb bones and limb girdle bone listed in the other options are appendicular.

   Reference: Anatomy and Physiology 2e, Chapter 7 Review — 7.1, Divisions of the Skeletal System

3. 3For a hospital outpatient encounter, a physician documents only a suspected diagnosis. How should the coder treat that diagnosis?

   1. A. Do not code it as established; code the supported reason for the visit
   2. B. Code it as established when the physician says suspected
   3. C. Code it as established when it appears in the final note
   4. D. Sequence it first and add a symptom code only if available

   Answer: A

   Explanation: The outpatient guideline says, "Do not code diagnoses documented as “probable”, “suspected,” “questionable,” “rule out,”" and other uncertain terms. The suspected condition is therefore not coded as confirmed; the documented reason for care is used.

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — Section IV.H, Uncertain diagnosis, p. 114

4. 4Under Original Medicare, which part helps cover an inpatient hospital stay?

   1. A. Part A
   2. B. Part B
   3. C. Part C
   4. D. Part D

   Answer: A

   Explanation: Medicare.gov states, "Part A helps cover inpatient care in hospitals". Part B focuses on medical and outpatient care, Part C is an alternative plan, and Part D is drug coverage.

   Reference: Parts of Medicare — Part A (Hospital Insurance)

5. 5What is the geographic reach of a Medicare national coverage determination?

   1. A. It addresses Medicare coverage on a national basis
   2. B. It applies only within one MAC’s area
   3. C. It applies only to one hospital’s claims
   4. D. It applies only to one beneficiary’s appeal

   Answer: A

   Explanation: CMS states, "NCDs limit specific Medicare service, procedure, or technology coverage on a national basis." This distinguishes an NCD from a local determination.

   Reference: Medicare Advance Written Notices of Non-coverage — p. 7, Coverage decisions

6. 6A patient presents for scheduled outpatient surgery, but the operation is cancelled because of a contraindication. Which condition is first-listed?

   1. A. The reason for the planned surgery
   2. B. The contraindication in every case
   3. C. An aftercare diagnosis
   4. D. A routine examination code

   Answer: A

   Explanation: The outpatient guideline says, "code the reason for the surgery as the first-listed diagnosis (reason for the encounter), even if the surgery is not performed due to a contraindication."

   Reference: ICD-10-CM Official Guidelines for Coding and Reporting FY 2027 — FY 2027 p. 112, Outpatient Surgery

7. 7What is the main coding role of HCPCS Level II relative to CPT?

   1. A. Identify products, supplies, and services not included in CPT
   2. B. Classify only inpatient principal diagnoses
   3. C. Replace the five-digit CPT system for every physician service
   4. D. Assign hospital inpatient MS-DRG weights

   Answer: A

   Explanation: CMS describes Level II as used "primarily to identify products, supplies, and services not included in the CPT® codes."

   Reference: Healthcare Common Procedure Coding System (HCPCS) — HCPCS Level II overview

8. 8A radiology department repeats images during one encounter because the first set has substandard quality. How should the repeated study be reported under Medicare NCCI policy?

   1. A. As a second complete study
   2. B. As one unit of the appropriate study
   3. C. As a separate limited study
   4. D. As two units with a repeat modifier

   Answer: B

   Explanation: CMS states, "If imaging studies (e.g., radiographs, computerized tomography, magnetic resonance imaging) are repeated during the course of a radiological encounter due to substandard quality or need for additional views, only one unit of service for the appropriate code may be reported." The repeat corrects image quality within the same radiological encounter.

   Reference: CMS NCCI Policy Manual, Chapter IX: Radiology Services — Section C.1, p. IX-5

9. 9Which circumstance supports reporting modifier 22 on a surgical procedure under the NCCI policy?

   1. A. A procedure is performed at a new site
   2. B. Services are substantially more extensive than usual
   3. C. A second surgeon participates
   4. D. The patient has multiple diagnoses

   Answer: B

   Explanation: CMS states, "This modifier shall not be reported unless the service(s) performed is (are) substantially more extensive than the usual service(s) included in the procedure described by the HCPCS/CPT code reported." Substantially increased procedural work is the controlling condition.

   Reference: CMS NCCI Policy Manual, Chapter I: General Correct Coding Policies — Section E.a, p. I-15

10. 10Operative note: A vaginal hysterectomy removes a uterus weighing 220 g along with both tubes and ovaries. Which CPT reporting best captures the complete procedure?

    1. A. 58260 plus 58720
    2. B. 58260 alone
    3. C. 58262
    4. D. 58720 alone

    Answer: C

    Explanation: CMS states, "the provider/supplier shall report CPT code 58262 (Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s))." The comprehensive hysterectomy code includes tube and ovary removal for this uterus size.

    Reference: CMS NCCI Policy Manual, Chapter I: General Correct Coding Policies — Section A, p. I-5