Rny to Distal Rny Revision
I agree your surgeon's office should be able to help you. When I was getting ready to apply for my revision. My surgeon wrote a letter explaining why it was medically necessary, had me write a justification letter (mine was 5 pages long, he expressed that I had to be articulate in my success with the initial surgery, my compliance, exercise routine, dietary compliance and why it failed me, also to be specific in non-surgical ways I had attempted to lose the additional weight such as Weigh****chers, Atkins, etc, and why I felt that a revision surgery was justified), also I had a nutritional evaluation which the nutritionist also wrote it wasn't a compliance issue, and a behavioral evaluation which the specialist also wrote a justification to show it wasn't behavioral but was truly believed to be medical in nature and I also had an upper GI, too.
My surgeon's office was extremely helpful with providing me a "to do" list. I would give the surgeon's office a call and see if they could assist you in your appeal. I would also call the insurance and see what they need to show it being "medically necessary".