Staying “Home Alone” Can Result in a Multitude of Injuries

Tune in to this monthly online coding column from Melanie Endicott to learn about challenging areas and documentation opportunities for ICD-10-CM/PCS.


It’s been 24 years since Kevin McCallister was accidentally left at home while the rest of his family went on vacation in the movie Home Alone. Poor little Kevin has to defend his family home when two con men try to rob it on Christmas Eve. Kevin outsmarts the idiotic burglars with booby traps which result in a multitude of injuries (with a couple insults added in). The coders certainly had their work cut out for them with those two (injuries have been coded in ICD-10-CM).

 

Hit in chest with a crowbar = Fracture multiple ribs (bilateral) and punctured left lung

o   S22.43XA, Multiple fractures of ribs, bilateral, initial encounter

o   S27.391A, Other injuries of lung, unilateral, initial encounter

o   Y00.XXXA, Assault by blunt object, initial encounter

 

Code Cracker Stairs and IceSlip on ice and fall down flight of stairs = Contusions to back (left, upper) and scalp

o   S20.222A, Contusion of left back wall of thorax, initial encounter

o   S00.03XA, Contusion of scalp, initial encounter

o   W00.1XXA, Fall from stairs and steps due to ice and snow, initial encounter

 

Grabbing red hot doorknob = Third degree burns to palm and fingers of right hand

o   T23.351A, Burn of third degree of right palm, initial encounter

o   T23.341A, Burn of third degree of multiple right fingers, including thumb, initial encounter

o   X19.XXXA, Contact with other heat and hot substances, initial encounter

 

Blowtorch to the head = Third degree burns to scalp

o   T20.35XA, Burn of third degree of scalp [any part], initial encounter

o   X08.8XXA, Exposure to other specified smoke, fire and flames, initial encounter

 

Stepping on nail = Puncture wound to left foot with tetanus infection

o   S91.332A, Puncture wound without foreign body, left foot, initial encounter

o   A35, Other tetanus

o   W22.8XXA, Striking against or struck by other objects, initial encounter

 

Iron to the face = Blow-out fracture and nose fracture

o   S02.3XXA, Fracture of orbital floor, initial encounter for closed fracture

o   S02.2XXA, Fracture of nasal bones, initial encounter for closed fracture

o   Y00.XXXA, Assault by blunt object, initial encounter

 

Code Cracker Broken OrnamentsWalking on broken Christmas ornaments = Glass fragments in both feet

o   S91.342A, Puncture wound with foreign body, left foot, initial encounter

o   S91.341A, Puncture wound with foreign body, right foot, initial encounter

o   W25.XXXA, Contact with sharp glass, initial encounter

 

Hit in face with paint cans = Maxillary fracture and knocked out teeth

o   S02.401A, Maxillary fracture, unspecified, initial encounter for closed fracture

o   K08.119, Complete loss of teeth due to trauma, unspecified class

o   Y00.XXXA, Assault by blunt object, initial encounter

 

Hit in back of head with snow shovel = Concussion with unconsciousness for 10 minutes

o   S06.9X1A, Unspecified intracranial injury with loss of consciousness of 30 minutes or less, initial encounter

o   Y00.XXXA, Assault by blunt object, initial encounter

 

BB gun shot to the forehead = Skin laceration

o   S01.81XA, Laceration without foreign body of other part of head, initial encounter

o   X95.01XA, Assault by airgun discharge, initial encounter

 

Slip and fall on Hot Wheels toy cars = Lumbar sprain

o   S33.5XXA, Sprain of ligaments of lumbar spine, initial encounter

o   W01.0XXA, Fall on same level from slipping, tripping and stumbling without subsequent striking against object, initial encounter

 

When assigning the external cause codes, additional codes should be assigned to each of these cases to indicate the place of occurrence, activity and status. See example below:

  • Y92.011, Dining room of single-family (private) house as the place of occurrence of the external cause
  • Y93.89, Activity, other specified
  • Y99.8, Other external cause status

 

Unfortunately, ICD-10-CM doesn’t provide an activity code for “burglary” or an external cause status for “criminal,” so the “other” categories must be used.

Those burglars would be wise to avoid the McCallister home in the future!

 

Melanie Endicott, MBA/HCM, RHIA, CDIP, CCS, CCS-P, FAHIMA, is senior director of HIM practice excellence, coding and CDI products development at AHIMA. She has over 15 years experience in HIM and coding, with her most recent focus being in ICD-10-CM/PCS, and has presented numerous times at the regional, state, and national levels on HIM and coding topics. She was previously a director of HIM practice excellence, focusing on coding products, resources, and education, at AHIMA. Melanie is an AHIMA-approved ICD-10-CM/PCS trainer and an ICD-10 Ambassador.

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