When it comes to organic molecules, it's usually easier to look at the bonds an atom makes. In acetyl coA, the carbonyl carbon has one bond to C, one bond to S, and two bonds to O. C is equally electronegative as C, so that bond earns a 0 for the C. S is more electronegative than C, so that bond earns a +1 for the C. O is more electronegative than C, so both of those bonds earn a +1 each for the C. From the four bonds, C gets a 0, +1, +1, and +1. The total is +3, so it gets a +3 oxidation state assigned to it.
Just to make sure it works, consider an aldehyde. The carbonyl C has a bond to C, a bond to H, and two bonds to O. It gets a 0 for the bond to C, a -1 for the bond to H, and +1 each for the two bonds to O. Overall it gets a 0 -1 +1 +1 = +1, so its oxidation state is +1.
Double checking with one more, let's consider carbon 2 of 2-butanol. Carbon 2 has two bonds to C, one bond to H, and one bond to O. It gets a 0 for each bond to C, -1 for the bond to H, and a +1 for the bond to O. Overall it gets a 0 for its oxidation state.
If there is a formal charge on an atom, that gets considered too.