StacksVerified U.S. regulatory reference

42 CFR §476.85

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
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—
  1. (a)The initial denial determination is reconsidered and revised; or
  2. (b)The change as a result of DRG validation is reviewed and revised.