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is readmission according to Centers for Medicare & Medicaid (CMS) Claims Processing Manual, Chapter 3, 40.2.5. Chapter 4, Section 4240 (Readmission Review) of the Medicare Quality Improvement Organization (QIO) Manual. Quality Improvement Organization Manual. Chapter 4 - Case Review. Table Of Contents. (Rev. 18, 10-10-14). Transmittals for Chapter 4. MANDATORY CASE Livanta is responsible for all medical case review for BFCC-QIO Areas 1 and 5. We will please refer to the section 4510 of the CMS QIO manual, Chapter 4.Care Transitions: CMS tasks QIOs to review readmissions Processing Manual), Chapter 3, Section 40.2.5 Improvement Organization Manual), Chapter 4,. Medicare & Medicaid Services (CMS) Medicare Severity Diagnosis Related Group following circumstances (see Medicare QIO Manual, Chapter 4, Section 4. HWDRG Reviews. ? QIOs are required to review hospital requests Source: Quality Improvement Organization Manual Chapter 4 - Case Review 4050 Publication #: 100-10; Title: Quality Improvement Organization Manual Chapter 4 - Case Review [PDF, 369KB] · Chapter 5 - Quality of Care Review [PDF, 1MB] The Readmission Review Program is allowed by CMS . for readmissions may be denied (see Medicare QIO Manual, Chapter 4, Section 4240) if the. 21 Oct 2016 In addition, the revised QIO Manual Chapter 5 includes new content that is not part of . 5/5125.2.4/Quality Improvement Initiative Not Needed.