42 C.F.R. § 476.85

Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

Last amended: 2017Year: 2026Length: 49 wordsSubsections: 2Official source

Cite as 42 C.F.R. § 476.85 (2026)

A QIO initial denial determination or change as a result of DRG validation is final and binding unless, in accordance with the procedures in part 473— (a) The initial denial determination is reconsidered and revised; or (b) The change as a result of DRG validation is reviewed and revised.
42 C.F.R. § 476.85: Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations. | Justis AI