View all text of Subjgrp 185 [§ 476.83 - § 476.170]
§ 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.
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.