Discuss the legal requirements for pharmaceutical reimbursement in terms of the application of the National Drug Code (NDC) to the coding and billing function in the following scenario

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Discuss the legal requirements for pharmaceutical reimbursement in terms of the application of the National Drug Code (NDC) to the coding and billing function in the following scenario.

 

 While reviewing a rejected claim as a clinical documentation analyst, you noticed that a hysterectomy on a patient was recorded in the medication reconciliation section of the EHR as hysteroscopy. After comparing the two, you noticed that hysteroscopy costs way less than the actual procedure done on the patient. Upon further digging, you discovered that the error had happened repeatedly during the same year. You also found that hysterectomy is just one step up from hysteroscopy on the drop-down box in the medication reconciliation section in the EHR.