---
kind: "section"
citation: "42 C.F.R. § 478.10"
title: "42"
number: "478.10"
heading: "Scope."
url: "https://uscodex.org/cfr/42/478.10"
---

# §478.10. Scope.


This subpart establishes the requirements and procedures for—

- (a) Reconsiderations conducted by a Utilization and Quality Control Quality Improvement Organization (QIO) or its subcontractor of initial denial determinations concerning services furnished or proposed to be furnished under Medicare;
- (b) Hearings and judicial review of reconsidered determinations; and
- (c) **QIO review of a change in diagnostic and procedural coding information.**

## Notes

### Amendments

[50 FR 15372, Apr. 17, 1985; 50 FR 41887, Oct. 16, 1985. Redesignated at 64 FR 66279, Nov. 24, 1999]

### Source

Source: 50 FR 15372, Apr. 17, 1985, unless otherwise noted. Redesignated at 64 FR 66279, Nov. 24, 1999.

### Authority

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

### Amendments

[50 FR 15372, Apr. 17, 1985; 50 FR 41887, Oct. 16, 1985. Redesignated at 64 FR 66279, Nov. 24, 1999]