{"data":{"id":"us/42-cfr-476.85","jurisdiction":"us","citation":"42 CFR 476.85","heading":"Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.","body":"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—\n(a) The initial denial determination is reconsidered and revised; or\n(b) The change as a result of DRG validation is reviewed and revised.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER F—QUALITY IMPROVEMENT ORGANIZATIONS","PART 476—QUALITY IMPROVEMENT ORGANIZATION REVIEW","Subpart C—Review Responsibilities of Quality Improvement Organizations (QIOs)"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"9c3fce23657ae8abaddccdf72077864bd4a89347fe2c20462b4e14af149a204f","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-476.84","next":"us/42-cfr-476.86"},"notice":"GroundRules: Original legal text. Not legal advice."}