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Modifier 78 or 79? Lt Quad Repair during global of Lt TKR

Hi, I am hoping someone could clarify what modifier I should use during the global period of a Lt TKR for pain relief and also Lateral Release for the chronically dislocating patella. Pt has Multiple Sclerosis with a chronically dislocating patella during the post op since he has had a number of falls and now presents with quad rupture. Thanks in advance.

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