Hurt for the Holidays—Coding the injuries of Home Alone
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By Alex Card
Everyone has their own holiday traditions: decorating a tree, lighting a menorah, perhaps tossing a shilling to a passing child in exchange for a goose. For many celebrants, watching holiday movies—and/or debating which movies truly belong to the genre—is another time-honored way of getting into the festive spirit.
Home Alone, the 1990 family comedy by Chris Columbus and John Hughes, is undeniably a Christmas movie. (Deniers, take your arguments to our comments section.) But in the third act, when “Wet Bandits” Harry and Marv finally break into the McCallister residence and invoke the wrath of young Kevin, the trio’s slapstick antics take on a tinge of body horror as the clever kid leads the would-be burglars into a series of surprisingly brutal, jury-rigged traps.
If the Wet Bandits arrived at the ER after their encounter with Kevin McCallister, their attending doctor would have plenty of questions—plus a lot of coding to pass along to the billing department. Let’s look at Kevin’s most injurious machinations and determine which ICD-10 codes would wind up on these bumbling burglars’ charts.
Heavy objects to the face
There are at least two instances of the hapless Harry and Marv walking face-first into Kevin’s jury-rigged boobytraps. In the first, Kevin rigs a steam iron to fall a full story down a laundry chute when the basement light cord is pulled. Marv pulls the cord and takes the iron straight to the face.
Depending on the weight of the iron and the height of the fall, poor Marv could be left with a fracture in his orbital socket (S02.3XX) or at the base of his skull (S02.1XX), a grievous eye injury (S05.9XX), or a concussion (S06.0X0A).
Marv would likely be among a very small cadre of patients to receive a concussion from a kid-crafted bludgeoning trap, but concussions in general are fairly common. According to Definitive Healthcare claims data, concussions without loss of consciousness accounted for 376,780 initial provider visits—about 14.9% of all intracranial injury-related visits (S06)—from January through November 2022.
Of course, the falling iron was just the first of Kevin’s skull-crushing contraptions. In a later scene, Kevin pulls the same trick with a partially full paint can, subjecting Harry to many of the same injuries his partner sustained earlier—and almost certainly aggravating Marv’s existing wounds. Thanks to the frontal angle of the impact, the Wet Bandits could also expect broken noses (S02.2XXA), shattered teeth (S02.5), and epidural hemorrhaging (S06.4) potentially leading to traumatic brain injury.
The American public seems to share Harry’s and Marv’s struggles with stumbling into obstacles face-first. Among skull and facial fractures (S02), fractured nasal bones and teeth were two of the most common reasons for provider visits in 2022. Broken noses accounted for 325,403 initial provider encounters from January through November (representing more than a quarter of visits for facial injuries), while trauma-induced tooth fractures led to more than 59,000 visits this year so far.
Multiple stair (and treehouse) falls
The Wet Bandits are not good with heights. The movie features several hard falls down multiple flights of stairs (and one long drop from a treehouse), which, in any reality outside of a family film, would probably result in some truly gnarly injuries.
Given how often Harry and Marv take tumbles—and compounded with the other harm they’ve sustained throughout their time in the McCallister house—the burglars could face herniated discs (M5126 and M5124), spinal fractures (S22.0), broken ribs (S22.3 and S22.4), and internal bleeding (R58), not to mention multiple concussions.
By this point, the Bandits have to be thinking about the quality of their health insurance, as the stair falls alone could require some costly treatments. Surgical spinal decompression procedures (63055 and 63056) can lead to charges between $6,200 and $9,700 on average, depending on where the spine was damaged, according to Definitive Healthcare claims data.
Any internal bleeding could require an exploratory laparotomy (49000) with an average charge of $2,442, negative pressure wound therapy (97606) with an average charge of $355, and/or blood vessel repair (35221) with an average charge of $4,930.
The burglary business isn’t known for robust health benefits, so I suspect Harry and Marv’s wallets will be hurting nearly as badly as their bodies by the end of this.
Flamethrower to the head (plus a shovel for good measure)
After being foiled by another one of Kevin’s traps, Harry reenters the house through an unlocked kitchen door, only to trigger a massive butane torch that spews fire directly onto his wool-capped head.
When the flames are extinguished and we see the aftermath, Harry’s unnaturally resilient dome looks to have received second-degree burns at worst (T20.2), but direct exposure to flame for so long would almost certainly result in third-degree burns (T20.3).
Interestingly, second-degree burns are the most common injuries in the “burns and corrosion of the head and neck” category (T20), with over 13,100 initial provider visits and about $54.3 million in total charges in 2022 so far.
Of all Kevin’s devious devices, this trap takes the cake (or Christmas cookies) for greatest harm inflicted, as actor Joe Pesci actually suffered real-life burns while performing the stunt for the film.
As if Harry’s and Marv’s skulls weren’t adequately battered over the course of their Christmas Eve, their attempted burglary concludes at the business end of a good Samaritan’s snow shovel. Rack up another couple of skull fractures, plus one last concussion—this time, with confirmed loss of consciousness (S060X9A).
The Wet Bandits probably aren’t representative of your target patient cohort. Luckily, we have the healthcare commercial intelligence—including diagnostic, procedural, and prescription claims data—to help you segment and target any part of the market, no matter how niche.
Get your organization a gift that keeps giving long after the holidays wrap up. Sign up today for a free trial with Definitive Healthcare, and discover new, trap-free paths to commercial success.