Question Modifier 58, 78 or 79 ?

mevans303

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hello, I have an outpatient facilitysurgery to code. The patient is 60 days post op from a Charcot reconstruction. after hardware removal had a post operative fall with tibia fx that was treated conservatively with immobilization and non weight bearing. upon follow up, skin is not healing well at the incision sites and high risk of of wound complications due to diabetes Charcot deformity and chronic kidney disease. The provider elected to do a wound debridement and removal of external fixation device and application of Myriad Matrix wound graft and Myriad matrix wound particles secured with staples. which would be the appropriate modifier in this scenario?
 
Which one do you think it should be? How would you do it?
Which definition of which modifier do you think applies?
Actually, I don't think any of those modifiers apply to this facility claim according to Codify. Am I looking at that correctly?
 
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