Ask Dr. Z

Femoral vein central venous line placement: Under ultrasound guidance, right femoral vein identified as being patent. Right groin prepped in sterile surgical fashion. Cannulated right femoral vein. Using a Seldinger technique, central venous line catheter was advanced. The cath was matured, dressing placed. Physician was queried for location of catheter tip and replied "No clinical reason to identify positioning of a femoral catheter. This is not standard of care." The CPT guideline, in part, states: "To qualify as a central venous access catheter or device, the tip of the catheter/device must terminate in the subclavian, brachiocephalic (innominate) or iliac veins, the superior or inferior vena cava, or the right atrium.” This guideline also states that central insertion sites are “jugular, subclavian, femoral vein or inferior vena cava catheter entry site.” Is it necessary for the physician/HCP to also document where the catheter terminates when it is inserted via a central vein such as femoral, jugular, subclavian? Thank-you.