1. LawStack
  2. Title 42 - Public Health
  3. Chapter IV - CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
  4. Subchapter F - QUALITY IMPROVEMENT ORGANIZATIONS
  5. Part 476 - QUALITY IMPROVEMENT ORGANIZATION REVIEW
  6. Subpart C - Review Responsibilities of Quality Improvement Organizations (QIOs)
  7. Topic - QIO Review Functions
  8. 42 CFR § 476.84
42 CFR § 476.84
Changes as a result of DRG validation
June 11, 2020
CFR

A provider or practitioner may obtain a review by a QIO under part 473 of this chapter for changes in diagnostic and procedural coding that resulted in a change in DRG assignment as a result of QIO validation activities.

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§ 476.83 Initial denial determinations
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§ 476.85 Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations

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