Revision received letter back from Cigna

I received a letter from Cigna regarding the revision they said I need not to respond they sent this to my Surgeon for more information to see if it was medically necessary. I wonder what do they need from the surgeon?

they prob want to know the results of any testing that has been done.

they are looking to see if there is a mechanical problem with your pouch/sleeve of if it is " user error" like you are eating too much or haven't followed the plan.