Nutrition evaluation & denial

Cigna denied me for the sleeve surgery on the basis of records not including a "nutritional evaluation" by a physician or RD AND because one of my diet visits did not include any exercise information. The doctors office keeps telling me the doctor will do a peer to peer to try to get it approved on the basis that they must not understand that the diet visits I did were with a RD.

My question is - did anyone have a specific nutrition evaluation in addition to the diet visits- similar to the psych eval? It has been two weeks and they have no update for me on when they will do the peer to peer and I do not want to sit around wasting time dragging this out because the insurance person at the office is incompetent/not doing her job. Can I get a separate nutritional evaluation done and send it on my own? Or should I start the appeal process and if I do that does it take away the ability to do a peer to peer?

I'm very frustrated with how this is going, and want to do whatever I can (short of switching doctors) to push this along.