As physicians move away from private practice and join hospital groups, career opportunities are opening for coders in outpatient facilities such as ambulatory surgical centers as well as hospital outpatient billing and coding departments. The COC exam demonstrates your specialized payment knowledge needed for these jobs in addition to your CPT, ICD-10, and HCPCS Level II coding skills.

The Certified Outpatient Coder (COC) Exam Review is an online course designed to prepare you for the COC Certification Exam offered by AAPC. (The COC was formerly known as the Certified Professional Coder-Hospital or CPC-H.)   The COC Exam Review is self-paced and provides valuable study and test-taking strategies.

The COC Exam Review is slated to be released in early 2018. To be notified when the COC Exam Review is available, click here.

Tuition: $249

Online Flexibility! Work at your own pace; save time and travel costs.

Note: For students who require in-depth outpatient coder training as well as preparation for the COC exam, please refer to our Medical Coder Career Program – Outpatient Coding

Student Interest Form

The COC Exam Review offers a comprehensive review of materials covered on the COC credential exam:

  • Proficiency in assigning accurate medical codes for diagnoses, procedures and services performed in the outpatient setting (emergency department visits, outpatient clinic visits, same day surgeries, diagnostic testing [radiology and laboratory], and outpatient therapies including physical therapy, occupational therapy, speech therapy and chemotherapy)
  • Proficiency across a wide range of services, which include evaluation and management, anesthesia, surgical services, radiology, pathology and medicine
  • Knowledge of coding rules and regulations along with keeping current on issues regarding medical coding, compliance and reimbursement under outpatient grouping systems. A trained coding professional can better handle issues such as medical necessity, claims denials, bundling issues and charge capture
  • Ability to integrate coding and reimbursement rule changes in a timely manner to include updating the Charge Description Master (CDM), fee updates and the Field Locators (FL) on the UB04
  • Correctly completing a CMS 1500 for ASC services and UB04 for outpatient services, including the appropriate application of modifiers
  • Knowledge of anatomy, physiology and medical terminology commensurate with ability to correctly code provider services and diagnoses
  • A working knowledge in the assignment of ICD-10-CM codes


“I am currently halfway through the COC program. It is the most comprehensive program I have seen. I have been an outpatient coder for 8+ years and this has answered many of my questions I have had throughout my career. I have been sharing your education site with many coworkers. You have the best training programs. Thank you!” — Pamela N., RHIT, CCS

“[Pam’s] outstanding achievements in staff development and mentoring have opened doors and touched the lives of many grateful new coders who would not have had the opportunity to expand their horizons without her.” — Journal of AHIMA, November – December 2013

“Thank you for all your help. Your team has always been open and dependable for clear advice and guidance. … [Y]our group has always shown they care about the student.” – Former student 

“Despite the difficulties of finding coders in rural Maine, Haney set a standard requiring all staff to be credentialled. She identified colleagues and students waiting to take their careers to the next level, and has mentored each one. She also led by example by earning her CCS credential along with the majority of her staff.” — AHIMA, in recognition of Pam Haney’s 2013 Triumph Award for Mentoring

“I truly thank you Libman Group for your wonderful courses that have contributed to my success.” — Leslie Jay Corn, CCS, CPC, CCA/ER Coding Analyst/Boston Medical Center OR LogixHealth 

“Pam should to be commended for her dedication to the Health Information Management profession especially in her role as a mentor to her employees, HIM students, and her colleagues.  Her willingness to provide support and opportunities for improvement and accomplishment has been ongoing throughout her career and continues on today as we approach our next challenge in transitioning to ICD-10.” — Millis Blackburn Perry, RHIA, CCS, CPC, Director of Coding Services, Synernet, Inc.

“Most recently I had two opportunities to work closely with Pam providing coder development education to her staff. Pam demonstrated her commitment to the development of her staff members by investing time and resources in their education.  She leads by example, asking others to do only what she herself is willing to do.  Pam facilitated the professional development of staff members lucky enough to have her as their boss.” — Mary Beth York, CCS, CCS-P, CIC, Barry Libman Inc.

“I greatly appreciate this support and outstanding customer service!” — former student

“I want to thank you so much for the fabulous presentation for our membership today that Pam Haney provided.  It was very informative and great information for our attendees.” — Gloria Litton, RHIA, CCS, Virginia HIMA, on Pam’s presentation for the VHIMA Webinar “Mastering Physician Queries in the Hospital Setting”

Angela Lehoux, BS, CCS, CDIP, CIC, COC, CPC-I

Director, Training and Operations
Angela Lehoux is a coder with 25 years of experience in inpatient, outpatient and emergency room coding; an instructor and education specialist for Libman Education courses; and Director of Training and Operations for Libman Education where she is responsible for ensuring that our training is accurate, easily accessible, and challenging. Angela believes in the transformational power of education to help individuals achieve their personal and career goals and for institutions to achieve operating success. Angela develops and reviews course content and is the teacher for Libman Education’s Medical Coder Career Program (MCCP), courses on ICD-10-CM and ICD-10-PCS, and review courses for the CCACCS, CIC, and COC credentials. Angela has provided in-house and on-demand training and mentoring of coding staff, as well as presentations on coding-related topics. Angela enjoys working individually with current students to answer their questions regarding course content and with prospective students to identify the appropriate curriculum to support their career objectives. Angela holds a bachelor’s degree in Healthcare Management and holds Certified Coding Specialist, Certified Documentation Improvement Practitioner from AHIMA as well as the Certified Inpatient Coder, Certified Outpatient Coder, and the Certified Professional Coder Instructor certifications from AAPC.

Pamela J. Haney, MS, RHIA, CCS, CIC, COC
Pamela J. Haney is the Coding Trainer Lead for the “American Apprenticeship Grant Program” at the AHIMA Foundation funded by the U.S. Department of Labor. While Director of Training and Education for Libman Education, Pam was responsible for the writing and/or development of online and instructor-led courses in health information management and medical record coding. An experienced educator, Pam serves as faculty and advisory committee member for medical coding and HIT programs, and has over thirty years experience as a Director of HIM and Coding Services. She is an AHIMA certified ICD-10 trainer and received the 2013 AHIMA Triumph Award in the Mentor category. Pam was a beta tester for the AAPC CIC™ exam and one of the first to receive the CIC™ certification.

The COC Exam Review course covers key COC exam content areas:

  • Medical terminology
  • Anatomy
  • Coding guidelines
  • Payment methodologies
  • Compliance
  • ICD-10-CM
  • CPT
  • HCPCS Level II coding
  • Surgery case practice
  • Understand the business side of outpatient services and ASCs
  • Differentiate between inpatient and outpatient services and payment methodologies
  • Understand the difference between MS-DRGs and APC assignment
  • Develop an understanding of compliance in the outpatient setting
  • Code a wide variety of patient services using CPT and ICD-10-CM
  • Apply coding conventions when assigning diagnoses and procedure codes
  • Understand how modifiers are used in the outpatient setting

The following are recommended prior to starting the course.

AAPC recommends the following eligibility to sit for the COC Exam:

  • Candidate must have at least two years medical coding experience.  (AAPC members with an apprentice designation are not required to have two years medical coding experience.)
  • AAPC recommends having an associate’s degree.

Note from AAPC: Due to the level of expertise required of medical coders, AAPC expects certified coders to be able to perform not only in an exam setting but also in the real world. In addition to passing the certification exam, coders will also be required to demonstrate on-the-job coding experience. Those who pass the COC exam but have not yet met this requirement will be designated as an Apprentice (COC-A) on their certificate

Required textbook and code books:

Other recommended resources:

  • Medical dictionary, any publisher
  • Anatomy and physiology reference
  • Merck Manual


To receive a Certificate of Completion, students must achieve a passing score of 70% or higher and complete 10 hours of contact instruction.

This program has the prior approval of AAPC for 10 CEUs. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

To receive CEU credit, students must achieve a passing rate on the course assessment(s). Students are able to repeat the course assessment(s) until they have mastered the material.

Students will have up to 16 weeks to complete the course. To receive an optional extension, contact Libman Education at [email protected] for pricing.

COC Exam Review
Tuition: $249

Financing available through PayPal CREDIT. Information available at checkout.

Do you have a group to enroll? Simply complete this form and email it to us at [email protected]. You can also call us for group pricing at 978-369-7180.

Students in this Libman Education course are eligible to receive a student discount on the AAPC COC examination. The retail price is $380; the student discount price is $300. When you complete this Libman Education course, you will be provided with the “Student Exam Discount Code” to use when you purchase the certification exam from AAPC.

Student Interest Form