COC CERTIFICATION EXAM PREP 2026 Latest
Comprehensive Study Guide — Certified Outpatient Coder
Review Outpatient Facility Coding • Detailed Rationales •
Verified Answers • Success Workbook
DOMAIN 1: OUTPATIENT ICD-10-CM CODING (Questions 1–25)
Question 1
A patient is seen in the hospital outpatient department for an initial encounter for a
closed, nondisplaced fracture of the left radial shaft. What is the correct ICD-10-
CM code?
A) S52.202A
B) S52.202A
C) S52.201A
D) S52.209A
Rationale: S52.202A is the correct code for a closed fracture of the shaft of the
left radius, initial encounter for closed fracture. The 7th character "A" indicates
initial encounter for closed fracture. S52.201A is for the right radius, and
S52.209A is for an unspecified radius.
Question 2
A patient with type 2 diabetes is seen in the outpatient clinic for a routine diabetes
check. The physician documents the patient is well-controlled on oral medications
with no complications. What is the correct ICD-10-CM code?
A) E11.9
B) E11.9
C) E11.65
D) Z79.84
Rationale: E11.9 is the code for Type 2 diabetes mellitus without complications.
Since the patient is well-controlled with no complications documented, E11.9 is
appropriate. Z79.84 is for long-term insulin use, which is not documented here.
,Question 3
A patient is seen in the outpatient surgery center for an excision of a benign breast
lesion. The pathology report confirms the diagnosis of fibroadenoma. What is the
correct ICD-10-CM code?
A) D24.9
B) N60.0
C) N60.0
D) D24.1
Rationale: N60.0 is the code for solitary cyst of breast (fibroadenoma). D24.9 is
benign neoplasm of breast, unspecified. Fibroadenoma is a specific type of benign
breast lesion, and N60.0 is the more specific code.
Question 4
A patient presents to the outpatient clinic with a cough, fever, and shortness of
breath. A chest X-ray shows infiltrates consistent with pneumonia. The physician
documents "community-acquired pneumonia." What is the correct ICD-10-CM
code?
A) J18.9
B) J15.9
C) J18.9
D) J15.9
Rationale: J18.9 is the code for pneumonia, unspecified organism. When the
physician documents "community-acquired pneumonia" without specifying the
organism, J18.9 is the correct code. J15.9 is for bacterial pneumonia, unspecified,
which is not documented here.
Question 5
A patient is seen in the outpatient clinic for a routine well-woman exam. The
patient is 45 years old and has no complaints. What is the correct ICD-10-CM
code?
,A) Z01.419
B) Z00.00
C) Z01.419
D) Z11.3
Rationale: Z01.419 is the code for encounter for gynecological examination
(general) without abnormal findings. Z00.00 is for a general adult medical
examination without abnormal findings. Since this is a well-woman exam, Z01.419
is more specific.
Question 6
A patient with chronic obstructive pulmonary disease (COPD) presents to the
outpatient clinic with an acute exacerbation. The physician documents "COPD
with acute exacerbation." What is the correct ICD-10-CM code?
A) J44.0
B) J44.1
C) J44.9
D) J44.0
Rationale: J44.1 is the code for COPD with acute exacerbation. J44.0 is COPD
with acute lower respiratory infection, and J44.9 is COPD, unspecified. Since the
documentation specifies acute exacerbation without mention of infection, J44.1 is
correct.
Question 7
A patient is seen in the outpatient clinic for a follow-up visit after a total knee
replacement. The patient is recovering well with no complications. What is the
correct ICD-10-CM code?
A) Z47.1
B) Z48.89
C) Z47.1
D) Z96.651
Rationale: Z47.1 is the code for aftercare following joint replacement surgery.
Z96.651 is for the presence of an artificial knee joint, which would be coded after
, the aftercare period is complete. Since this is a follow-up visit during recovery,
Z47.1 is appropriate.
Question 8
A patient is seen in the emergency department with chest pain. The physician
documents "atypical chest pain" after a workup that is negative. What is the correct
ICD-10-CM code?
A) R07.89
B) I20.9
C) R07.89
D) Z03.89
Rationale: R07.89 is the code for other chest pain (atypical chest pain). When a
definitive diagnosis is established, the definitive diagnosis is coded. Z03.89 would
be used for observation when the suspected condition is ruled out, but "atypical
chest pain" is a definitive diagnosis.
Question 9
A patient is seen in the outpatient clinic for a hypertensive urgency. The physician
documents "hypertensive urgency" and the patient's blood pressure is 180/110.
What is the correct ICD-10-CM code?
A) I10
B) I16.0
C) I16.9
D) I10
Rationale: I10 is the code for essential (primary) hypertension. Hypertensive
urgency is coded as essential hypertension, not as hypertensive crisis (I16.0-I16.9).
Hypertensive urgency does not have a specific code separate from essential
hypertension.
Question 10
A patient presents to the outpatient clinic with acute otitis media of the right ear.
What is the correct ICD-10-CM code?
Comprehensive Study Guide — Certified Outpatient Coder
Review Outpatient Facility Coding • Detailed Rationales •
Verified Answers • Success Workbook
DOMAIN 1: OUTPATIENT ICD-10-CM CODING (Questions 1–25)
Question 1
A patient is seen in the hospital outpatient department for an initial encounter for a
closed, nondisplaced fracture of the left radial shaft. What is the correct ICD-10-
CM code?
A) S52.202A
B) S52.202A
C) S52.201A
D) S52.209A
Rationale: S52.202A is the correct code for a closed fracture of the shaft of the
left radius, initial encounter for closed fracture. The 7th character "A" indicates
initial encounter for closed fracture. S52.201A is for the right radius, and
S52.209A is for an unspecified radius.
Question 2
A patient with type 2 diabetes is seen in the outpatient clinic for a routine diabetes
check. The physician documents the patient is well-controlled on oral medications
with no complications. What is the correct ICD-10-CM code?
A) E11.9
B) E11.9
C) E11.65
D) Z79.84
Rationale: E11.9 is the code for Type 2 diabetes mellitus without complications.
Since the patient is well-controlled with no complications documented, E11.9 is
appropriate. Z79.84 is for long-term insulin use, which is not documented here.
,Question 3
A patient is seen in the outpatient surgery center for an excision of a benign breast
lesion. The pathology report confirms the diagnosis of fibroadenoma. What is the
correct ICD-10-CM code?
A) D24.9
B) N60.0
C) N60.0
D) D24.1
Rationale: N60.0 is the code for solitary cyst of breast (fibroadenoma). D24.9 is
benign neoplasm of breast, unspecified. Fibroadenoma is a specific type of benign
breast lesion, and N60.0 is the more specific code.
Question 4
A patient presents to the outpatient clinic with a cough, fever, and shortness of
breath. A chest X-ray shows infiltrates consistent with pneumonia. The physician
documents "community-acquired pneumonia." What is the correct ICD-10-CM
code?
A) J18.9
B) J15.9
C) J18.9
D) J15.9
Rationale: J18.9 is the code for pneumonia, unspecified organism. When the
physician documents "community-acquired pneumonia" without specifying the
organism, J18.9 is the correct code. J15.9 is for bacterial pneumonia, unspecified,
which is not documented here.
Question 5
A patient is seen in the outpatient clinic for a routine well-woman exam. The
patient is 45 years old and has no complaints. What is the correct ICD-10-CM
code?
,A) Z01.419
B) Z00.00
C) Z01.419
D) Z11.3
Rationale: Z01.419 is the code for encounter for gynecological examination
(general) without abnormal findings. Z00.00 is for a general adult medical
examination without abnormal findings. Since this is a well-woman exam, Z01.419
is more specific.
Question 6
A patient with chronic obstructive pulmonary disease (COPD) presents to the
outpatient clinic with an acute exacerbation. The physician documents "COPD
with acute exacerbation." What is the correct ICD-10-CM code?
A) J44.0
B) J44.1
C) J44.9
D) J44.0
Rationale: J44.1 is the code for COPD with acute exacerbation. J44.0 is COPD
with acute lower respiratory infection, and J44.9 is COPD, unspecified. Since the
documentation specifies acute exacerbation without mention of infection, J44.1 is
correct.
Question 7
A patient is seen in the outpatient clinic for a follow-up visit after a total knee
replacement. The patient is recovering well with no complications. What is the
correct ICD-10-CM code?
A) Z47.1
B) Z48.89
C) Z47.1
D) Z96.651
Rationale: Z47.1 is the code for aftercare following joint replacement surgery.
Z96.651 is for the presence of an artificial knee joint, which would be coded after
, the aftercare period is complete. Since this is a follow-up visit during recovery,
Z47.1 is appropriate.
Question 8
A patient is seen in the emergency department with chest pain. The physician
documents "atypical chest pain" after a workup that is negative. What is the correct
ICD-10-CM code?
A) R07.89
B) I20.9
C) R07.89
D) Z03.89
Rationale: R07.89 is the code for other chest pain (atypical chest pain). When a
definitive diagnosis is established, the definitive diagnosis is coded. Z03.89 would
be used for observation when the suspected condition is ruled out, but "atypical
chest pain" is a definitive diagnosis.
Question 9
A patient is seen in the outpatient clinic for a hypertensive urgency. The physician
documents "hypertensive urgency" and the patient's blood pressure is 180/110.
What is the correct ICD-10-CM code?
A) I10
B) I16.0
C) I16.9
D) I10
Rationale: I10 is the code for essential (primary) hypertension. Hypertensive
urgency is coded as essential hypertension, not as hypertensive crisis (I16.0-I16.9).
Hypertensive urgency does not have a specific code separate from essential
hypertension.
Question 10
A patient presents to the outpatient clinic with acute otitis media of the right ear.
What is the correct ICD-10-CM code?
