Wiki modifier for repeat procedure for dislocation

pnwcoder

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Patient seen on 8/3/11 in ER for dislocated elbow and "under conscious sedation, the dislocation was reduced. A posterior splint was applied" (24600 billed). On 8/9/11 patient had re-dislocation of elbow and same physician in ER "The patient was given conscious sedation. The elbow was extended and anterior pressure was applied to the olecranon and slow flexion and the reduction was felt to have occurred. Put a cast on with the elbow flexed to slightly beyond 90 degrees" (24600 to be billed) On 8/16/11 Unstable right elbow, status post posterior dislocation and reduction x2, same physician to do "Closed reduction with application of posterior splint to the elbow on further flexion" "The patient was taken to the operating room, given general mask anesthetic. With the elbow extended, gentle traction and slow flexion, the reduction could feel to occur at approximately 70 degrees...cast applied (dx 718.32 w/24605).

Question is what modifer do I use with the two subsequent procedures? I've been advised that probably 58 but I'm not really sure that's correct. I bill for Dr who is specialst on call for hospital he is not ER Doc.
 
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