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Wiki Modifier 58 vs 78 another question

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ngrandmaison

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What would be the correct modifier to use in this case?

Patient is in global for primary repair of Achilles Tendon tear. Four weeks later the patient trips and falls causing a re-tear of the Achilles tendon. We are not using the the same procedure code for the repair, we are using "Secondary repair, Achilles tendon. Thinking 78 modifier would be the correct modifier, but always confused when the patient is in global and has an acute injury to the same area. Please help.
 
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