Learning: My New Port
Getting a port placed in my chest was not just a procedure. It was the beginning of learning an entirely new piece of medical equipment that will become part of my everyday cancer care. A port may sit quietly beneath my skin in my chest, but it carries important details: its manufacturer, model, construction material, catheter type, pressure limits (mine is rated for 300PSI), flow rate, imaging compatibility, and maintenance requirements. I have learned that knowing those details is not unnecessary medical trivia. It helps me ask better questions at infusion centers, imaging departments, emergency rooms, and every new facility where someone may need to access my port.
Before I go further, I want to be clear that I have no financial, professional, or promotional relationship with AngioDynamics, maker of my port. I am using the company and its products as an example because AngioDynamics manufactured the port that was implanted in me. Other manufacturers make implantable ports, and patients should always follow the instructions for their own specific device and care team.
For additional product specifications, model information, UPN listings, pressure and flow-rate details, and SmartPort CT identification features on my device, you can review the company’s product brochure:
View the AngioDynamics SmartPort brochure
My port is an AngioDynamics SmartPort CT Low-Profile titanium port. In the AngioDynamics product catalog, low-profile titanium models have UPNs (Unique Product Numbers) containing “LT”. I looked it up online and found out my port body is made from medical-grade titanium, while the catheter material may differ according to the exact model. The complete UPN on the implant record, product sticker, or patient identification card is therefore more useful than simply saying, “I have a SmartPort.”
The Patient Port Packet I Procured.
After my port was placed, I was given a small patient packet. At first glance, it looked like the kind of paperwork that could easily be set aside and forgotten. I quickly realized that it contained some of the most important information about the medical device now sitting beneath my skin.
The packet included:
A patient checklist
A blue-and-white silicone wrist bracelet identifying a Power Injectable Port and Smart Port
A sticker containing the port’s complete UPN code
A wallet-sized patient identification card
A smaller snap-off key-ring identification card
The model and identifying details of my port
A UCSD point of contact and telephone number for product or clinical questions
That wallet card should not live forgotten in a drawer. It should be carried and shown to anyone who plans to access the port. It gives the clinician important information about the model, pressure rating, flow limitations, and manufacturer. The smaller key-ring card provides an additional way to keep identification information nearby.
My practical approach is redundancy. I keep the physical card, photograph both sides of it, save the information on my phone, and make sure the details are included in my medical record. Phones lose power, patient portals can be incomplete, and different medical systems do not always communicate with one another.
The Port Patient App
AngioDynamics also offers a Port Patient App for people with its implantable ports. The app is available through the Apple App Store for iOS devices and Google Play for Android devices. It can be found by searching for “AngioDynamics” from a mobile device.
The app serves as a portable repository for information that may be needed during medical visits, including:
The model of the implanted port
The port’s maximum pressure and flow-rate specifications
Product-support information
The implantation date
Dates of previous procedures
The person that placed the port for me.
That information can be valuable when arriving at a new infusion center or imaging clinic where staff may not immediately see the full implant record.
I would still carry the physical identification card even when using the app. The best system is the one with backups: the app, the wallet card, a photograph of the card, and documentation in the chart.
What Makes the SmartPort CT Different?
From their website, the SmartPort CT family is designed for repeated vascular access, including medications, fluids, blood products, blood sampling, and—in approved circumstances—the power injection of contrast for imaging.
My specific port is rated for power injection at up to 300 PSI for contrast and other approved fluids used during my CT scans. That does not mean anyone should simply connect to it and begin an injection. The exact model must first be confirmed, the proper needle and technique must be used, and the imaging facility. Lab or infusion center must follow its own policy and the manufacturer’s instructions.
A power-injectable port is useful because it may reduce the need for a separate peripheral IV during a CT scan. But “power-injectable” is only part of the answer. The care team still needs to verify the device, confirm that the port is functioning properly, and ensure that the staff member accessing it is trained and authorized to do so.
Smart Angle Identification: The Port Can Be Recognized on Imaging
One feature I found especially interesting is the way SmartPort power-injectable ports can be identified on medical imaging.
SmartPort power-injectable ports can be identified by Smart Angle technology on the CT, CT Low-Profile, and Plastic CT models. The CT engraving on all models can be identified through a chest X-ray or CT scout scan.
Amazing.
That means the port does not rely only on a paper card or a patient remembering the model name. Its identifying features may also be visible on imaging. This can give clinicians another way to recognize that the device is a power-injectable SmartPort.
Even with that imaging feature, I would still want the complete model, UPN, pressure rating, and implant information confirmed before the port is used for power injection. Imaging identification is helpful, but it should work alongside the patient card, medical chart, manufacturer information, and facility safety procedures.
Vortex Technology: A Different Kind of Chamber
One of the features that interested me most was Vortex Technology. Rather than using a chamber with a perpendicular outlet, the Vortex design has a round reservoir and a tangential, or offset, outlet. Fluid enters in a way that creates a circular flushing action through the chamber.
The goal is to allow fluid to reach more of the chamber’s internal surface, reduce stagnant spaces, resist sludge buildup, and lower the possibility of an occlusion. The round chamber and offset outlet are designed to create a more complete flushing action inside the reservoir.
AngioDynamics cites a clinical study in which Vortex chamber ports were associated with a 73% reduction in port occlusions and 69% fewer secondary interventions compared with conventional ports. The company also cites an estimated average saving of $1,224 per patient compared with conventional ports. These are manufacturer-presented findings and should not be interpreted as a guarantee of what any individual patient will experience.
The newer AngioDynamics SmartPort+ platform combines Vortex chamber technology with additional catheter technology intended to resist thrombus accumulation. Vortex remains one of the key design features that distinguishes the port chamber itself.
A Port Can Be “Power-Injectable” and Still Require Questions
When I hear that my port is power-injectable, my next question is not simply, “Can you use it?” The questions I asked myself:
Has the exact model and UPN been confirmed?
Have I reviewed my port identification card?
At the Lab, I will ask if the port is currently functioning properly and giving blood return?
For the person accessing my port: are you using the manufacturer-approved power-injection needle and technique? A non-boring needle needs to be used.
Is there a Port Access Order in my medical chart?
Is the nurse or imaging clinician credentialed under the facility’s policy to access it?
What maximum flow rate and pressure apply to my exact port?
Will this facility use my port for CT contrast, or will it require a separate peripheral IV? I have a fried with a port and a PICC line, so asking if that is a possibility may be import to learn.
A device may be capable of something while a particular clinic is not authorized or equipped to perform it. Device approval, clinical orders, staff training, and facility policy all have to meet in the “same room.”
The card included in my patient packet will be shown to anyone who is going to access my port. It contains the details needed to confirm what the device is and how it may safely be used. It also provides a contact name and department (Interventional Radiology, IR) and a telephone number in case the clinician needs additional information.
Learning the CPT Codes
Here’s a related bit of information… Another part of the process that I found surprisingly valuable was learning about Current Procedural Terminology, or CPT, codes. CPT codes are used to describe medical procedures and services, and they can affect prior authorization, billing, and how an insurer evaluates a claim.
I learned to double-check which codes had been requested and approved for each procedure. That helped me form better questions before arriving:
Which CPT codes are being submitted for this procedure?
Were all necessary primary and add-on services included in the authorization request?
Does the approval cover the facility, physician, imaging guidance, anesthesia, and other separately reportable services?
Does the insurer’s authorization guarantee coverage, or could coding and medical-necessity rules still affect payment?
An authorization is important, but it is not always a promise that every component will be paid. Coding rules can also vary depending on the procedure, payer, documentation, and whether a service is considered bundled into another code. In my partial penectomy, by reviewing the codes I found my surgeon’s promise of at least one night in the hospital was not backed up by the billing (CPT) codes. After phone calls, I finally rescheduled surgery for the following week, with the proper codes included in the orders. CPT codes as far as I know are for the US, and I am not sure what type of billing or authorization codes are used in other locations.
CPT Code 76937: An Example of an Add-On Service
A useful example is CPT code 76937, which represents ultrasound guidance for vascular access procedures, such as central-line or arterial-line placement, meaning a port placement in my case.
It is an add-on code, meaning it must be reported in addition to the primary procedure rather than billed as a stand-alone service. It also requires specific documentation, including:
Confirmation that the selected vessel is open
Concurrent, real-time ultrasound visualization of the needle entering the vessel
Permanent image recording
An appropriate written report
Some procedures already include imaging guidance, and payer rules may prevent separate payment in certain circumstances. That is why the code should be confirmed by the clinical coding team and insurer rather than assumed to apply automatically. I found I could call my insurance company and they helped me understand my codes.
This is exactly why learning a little about CPT codes helped me. I was not trying to become a medical coder. I was trying to make sure that the procedure my physician ordered, the services the team expected to perform, and the services the insurer authorized were all describing the same event.
The Information I Want in My Own Record
For my own SmartPort, I want my medical chart and my personal records to include:
Manufacturer: AngioDynamics
Product family: SmartPort CT
Configuration: low-profile, single lumen
Port-body material: medical-grade titanium
Complete UPN and catheter details
Implantation date and implanting facility
Power-injection rating of 300 PSI
Maximum approved flow rate
MRI-conditional information
Port Access Order, when required
Maintenance and flushing schedule
Who may access it at infusion and imaging facilities
Product-support contact name and telephone number
I also look forward to my doctor providing a Port Maintenace procedure and schedule.
The port itself may be small, but the information surrounding it is not. Knowing the model, understanding what “power-injectable” really means, keeping the patient packet, installing the phone app, wearing the wristband when I am away from home, carrying the D card, and having the UPN information available, and asking about CPT codes all give me a clearer role in my own care.
Cancer already comes with enough uncertainty. I cannot control every part of it. But I can learn the name of the device in my chest, understand how it was designed, carry the information that explains it, and make sure the right questions are asked before someone accesses it.
One day at a time. One question at a time.
—Ty