---
kind: "section"
citation: "42 C.F.R. § 476.85"
title: "42"
number: "476.85"
heading: "Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations."
url: "https://uscodex.org/cfr/42/476.85"
---

# §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](/cfr/42/part473.md)—

- (a) The initial denial determination is reconsidered and revised; or
- (b) **The change as a result of DRG validation is reviewed and revised.**

## Notes

### Source

Source: 50 FR 15330, Apr. 17, 1985, unless otherwise noted. Redesignated at 64 FR 66279, Nov. 24, 1999.

### Authority

Authority: 42 U.S.C. 1302 and 1395hh.

### Source

Source: 44 FR 32081, June 4, 1979, unless otherwise noted. Redesignated at 64 FR 66279, Nov. 24, 1999.