Wiki Revision ACDF during global

fltbaroque

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Patient has a fall within 2 weeks of ACDF and returns to the operating suite. New diagnosis is "mechanical complication of implant". Surgery is revision of ACDF with increased difficulty (22 modifier).
My question is this: which modifier would you use?
58 - because it's more extensive than the first surgery?
78 - because it was not planned at the time of the first surgery?
79 - not related because the patient fell and there's a new diagnosis?

Thanks!
 
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