Ask Dr. Z

I have a provider that did a radial access attempts to advance the J wire into the aorta from the right radial was not successful, therefore a JR cath was advanced to the level of proximal subclavian and an angiogram was performed. Apparent that the pt had about 75-80% right sublcavian stenosis. Glide wire was advanced into the ascending aorta and the JR-4 and AL-2 multiple angulated view of the Rt and Lt coronary performed. JR-4 was used to selective engage the vein graft to the RAMUS and vein graft to the marginal and selective angiography of these grafts were performed. LIMA was patent because of competitive flow in LAD. No attempt was made initially to engage the LIMA. At this point the provider did a common femoral arterial access was obtained, LIMA cath was selective engaged into the left internal mammary, angio performed. Pigtail cat was advanced into the ascending aorta, aortic root ang was performed. AL-6 guiding cath then selectively engaged into the the Rt coronary artery, multiple agulated views of Rt coronary artery were performed. This was performed after 300mics of IC nitroprussied. Pt given ANGIOMAX bolus and drip in .014 whisper wire dilated from distal RCA to mid RCA. Drug eluting stent was then done.

My question on this case is can I bill anything for the first access that was not able to complete the heart cath?
I have one coder that feels we should bill 93459, 93459-59 or 74, G0290,93567.

The other coder feels we should bill 93459,G0290,93567 and 36216 and 75710 for the subclavian access and angio.

Any guidance you can give use on this case would be greatly appreciated.
Thank you for your assistance.