What To Expect For CPC and CCA Exams In 2026

As we approach 2026, students preparing for medical coding certifications like the CPC (Certified Professional Coder from AAPC) and CCA (Certified Coding Associate from AHIMA) face an exciting yet demanding landscape. The field continues to evolve with annual code updates, emphasis on accuracy, and a focus on real-world application. Here’s what you should realistically expect if you’re planning to sit for these exams in 2026.

Key Updates and Code Set Changes for 2026

Both certifications heavily rely on the current year’s codebooks. For exams taken in 2026:

ICD-10-CM (diagnosis codes): The FY 2026 updates took effect on October 1, 2025, with hundreds of changes. Expect around 487 new codes, dozens of deletions, and revisions. Key focus areas include expanded codes for social determinants of health (SDoH) (e.g., financial insecurity specifics), new codes for eyelid inflammations, thyroid orbitopathy, glaucoma subtypes, rheumatoid factor abnormalities, and more detailed injury/flank-related diagnoses. There may also be mid-year updates (e.g., April 1, 2026 additions like new ICD-10-PCS codes).
CPT® (procedure codes): The 2026 edition includes significant changes — approximately 288 new codes, 84 deletions, and 46 revisions (totaling over 400 updates). These often impact surgical procedures, evaluation & management (E/M), and specialty areas.
HCPCS Level II: Expect annual revisions, especially for drugs, supplies, and Medicare-related items.

For CPC (AAPC) → Exams use the current year’s books (e.g., CPT® 2026, ICD-10-CM 2026). The exam blueprint remains aligned with physician office/outpatient coding, emphasizing application over rote memorization.

For CCA (AHIMA) → Codebooks update periodically; by 2026, you’ll need the 2025 or 2026 editions depending on test date (e.g., 2025 books effective until ~April 2026, then newer). The exam covers both inpatient/outpatient with a strong focus on ICD-10-CM/PCS and CPT®.

Exam Format and Structure

The core structure remains consistent, but preparation must reflect the latest guidelines.

CPC Exam (AAPC)

100 multiple-choice questions
4 hours to complete
Open-book (bring approved codebooks)
Covers 17 knowledge areas: anatomy/physiology, medical terminology, ICD-10-CM, CPT®, HCPCS, modifiers, compliance, E/M services, surgical coding by body system, and more.
Heavy emphasis on applying codes to scenarios (e.g., operative reports), E/M leveling (2026 logic), NCCI edits, and sequencing.
Expect realistic case-based questions that test speed and accuracy under timed pressure.

CCA Exam (AHIMA)

105 questions (90 scored + 15 unscored pretest items)
2 hours
Open-book (must bring approved codebooks — e.g., 2025/2026 ICD-10-CM/PCS and CPT® Professional Edition)
Six domains: Clinical Classification Systems (~30-34%), Health Records & Data Content, Compliance & Regulatory, etc.
More broad entry-level focus, including data quality, reimbursement methodologies, and both inpatient/outpatient coding.
Questions often require understanding clinical concepts and code assignment rules.

Both exams are computer-based at testing centers (Pearson VUE for AHIMA, various proctored options for AAPC).

What to Expect in Preparation and on Test Day

Increased Emphasis on Updates — 2026 exams will test your knowledge of the latest code changes. Many candidates fail by using outdated books or ignoring guideline revisions (e.g., new SDoH sequencing rules).
Time Management Pressure — Especially on the CPC. With 100 questions in 4 hours, you’ll need to quickly navigate codebooks. Practice with full-length timed mocks.
Scenario-Based Questions — Both exams use realistic medical records, operative reports, and charts. Expect to assign codes, append modifiers, and avoid bundling errors.
Open-Book Reality — Bring approved books (tabbed/annotated legally). Knowing where to find info fast is crucial.
Study Resources — Use updated 2026 study guides, AAPC/AHIMA practice exams, and courses. Many new prep books include 500–2000+ practice questions, mock exams, and rationale explanations tailored to the 2026 blueprint.
Pass Rates & Difficulty — CPC remains challenging (pass rates often ~60-80% on first attempt with solid prep). CCA is entry-level but still requires strong foundational knowledge.

Tips for Success in 2026

Start with the official guidelines (ICD-10-CM/PCS, CPT®) and focus on changes effective October 1, 2025.
Practice daily with realistic scenarios — aim for 100+ questions/week.
Master anatomy/terminology and E/M guidelines.
Take multiple full-length practice exams under timed conditions.
Join study groups or forums (e.g., AAPC/AHIMA communities) for tips.
Schedule your exam after thorough prep — retake policies apply (e.g., 30-90 day wait).

In summary, 2026 brings fresh code updates and continued emphasis on precision, compliance, and application. With focused preparation using current materials, you’ll be well-positioned to pass the CPC or CCA and launch your medical coding career. Stay consistent, practice relentlessly, and good luck — your certification is closer than you think! 🚀

——————————————————

Originally Published On: Medical Coding News

Photo courtesy of: Getty Images

Follow Medical Coding Pro on Twitter: www.Twitter.com/CodingPro1