§ 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.