CFR /  Title 42  /  Part 476  /  Sec. 476.85 Conclusive effect of QIO initial denial determinations

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.