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CCCS NCE guide

Please read this guide in full before completing the application.

Section 1: Becoming certified

Information on the Certified Classification and Coding Specialist (CCCS) designation, professional designation, and eligibility criteria to write the classification and coding certification examination may be found here. The objective of the
certification examination is to assess the proficiency and accuracy of classification and coding of complex cases beyond
the entry-to-practice level for ICD-10-CA and CCI classifications in acute care settings.

Section 2: Code of ethics

The code of ethics and the interpretation guidelines to support it are available here.

Section 3: Examination application

To register for an examination, candidates must submit an application and provide payment. The CCCS NCE application guide can be found here.


Applicants are responsible for reviewing all information to ensure it is correct in both the application and the CHIMA membership profile.

  • Name: This information is used to prepare certificates for successful candidates. Please contact [email protected] to include a middle name or initial if it is to be included on the certificate.
  • Address: Applicants are responsible for ensuring a current address is included in the application and is updated in the online membership profile.
  • Email address: An applicant must provide a primary email address. Please ensure it is correct, as correspondence following receipt of a candidate’s examination application, including the provision of an examination password, will be carried out via email once the application is approved. If a current email address is not provided, the applicant will not receive any follow-up information.

Section 4: Examination content

The CCCS examination consists of a total of 45 questions (42 multiple choice questions and 3 case scenarios) in an allotted time of 2 hours and 12 minutes (132 minutes). The examination questions are developed by industry experts and replicate complex scenarios and situations found in acute care settings. The examination evaluates six competency areas:

  1. Fundamentals
  2. General medicine
  3. Neoplasms
  4. Interventions
  5. Obstetrics and newborns
  6. Iatrogenic disorders, trauma, and other related conditions and disorders

Please refer to the examination primer for additional information about the content of the examination

Section 5: Studying for the examination

Examinations can be a stressful experience, and preparation can help minimize stress by re-affirming the knowledge that a candidate has while assisting in the identification of areas that may require additional review. It is best to study one subject area/topic at a time. Focus time (ideally a significant period, such as a few hours over several days) to that subject. Do not try to review multiple/different subjects in a shorter period. Take frequent short breaks to provide both mental and physical separation from the topic and workspace, allowing for the opportunity to ‘recharge.’

Study well in advance of the examination. Do not wait until the week or night before the examination.

Examination primer

An examination primer is a valuable tool to assist any individual preparing to write an examination. Based on the classification and coding domains and subdomains, it identifies each learning outcome with a few examples of the knowledge content. It also provides some practice questions and helpful tips for preparing for the exam. Examination primers are available on the CHIMA website.

Other study resources

  • ICD-10-CA/CCI Classification Primer by Joy Fletcher has practice questions with an answer key and highlights coding principles throughout the chapters
  • The Canadian Institute for Health Information (CIHI) offers informational and educational resources on their website to assist coders

Section 6: Writing the examination

Examination candidates are responsible for purchasing or arranging access to the following resources, which must be
preinstalled on the computer prior to the examination date:

  1. Canadian Coding Standards (v. 2018)
  2. ICD-10-CA/CCI Folio (v. 2018) software

Please make sure to open the Folio software and the Canadian Coding Standards document prior to the examination
start time.

IMPORTANT: Examination candidates are responsible for purchasing or arranging access to ICD-10-CA/CCI Folio software. The Folio software and Canadian Coding Standards must be preinstalled on the computer being used to access the examination. Do not wait until the day of the examination to install software on the computer. Examination candidates must not access any other websites or documents during the entire examination.

Section 7: Grading the examination

All multiple-choice questions are computer graded. Each correct multiple-choice question is worth one mark. The examination score will be the total of correct answers. Final results are calculated as a percent (%) of the marks achieved by a candidate in all examination competencies in order to determine each candidate’s certification status.

To pass the examination, candidates must attain an overall minimum mark of 70%. Candidates who achieve this examination outcome are ‘certified,’ while candidates who do not achieve this examination outcome are ‘not certified.’


A candidate who is unsuccessful writing the CCCS NCE on the first attempt may re-write the examination twice more
(for a total of three times). Regular pricing applies for subsequent attempts. The exam candidate must complete the entire
examination each time. If a candidate has failed all three attempts, a further review will be conducted.

Questions related to examination administration and processes should be directed to CHIMA at [email protected]