Reasons that make the surgery medically necessary?

My insurance says that surgery must be medically necessary. The Dr. that I have chose to see needs a letter of referal that gives reasons why I should go see this Dr.. I just want to make sure that I do everything right and don't give the insurance company any reasons to not ok the surgery. I have depression (have been hospitalized), reflux, and have weak ankles and knees. Other than that there's not much wrong with me. I don't think that my insurance company will think any of that makes the surgery necessary. Although I have tried to commit suicide twice. What are some of the reasons that would make this surgery necessary? Help, please.

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