Just as an update (and we can discuss tomorrow), the new visit detail table allows us to link together procedures. So, one possible approach to modifiers is to drop the modifier column, and to treat modifiers as procedure records. These can all share the same visit id as the HCPCS code to which they are associated, and they can also share the same visit detail id. Hence, it should be easy to keep them together, regardless of whether there is 1 or 10 modifiers.
We will still have to map some of the modifiers to other domains, but the process will still work. That is, even if a modifier is a condition occurrence, it can have the same visit id and visit detail id as the original HCPCS code.
We can discuss this at the next meeting.