Help Me!!!!!!! I have been denied by cigna

I have been denied by cigna(imagine that)The denial letter said that ther was no polysomnogram to support sleep apnea. I had a polysomnogram done and the result was RDI of 47 per hour. We appealed with this in hand as well as proof of degenerative joint disease. Appeal denied...36 year old male with sleep apnea and degenerative joint disease did not provide enough medical neccesity and there was no psych eval or 12 week supervised diet in the last year. These things were not mentioned in their original denial. What do I do?

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