As an update, I emailed twitter support and they eventually approved the ad campaign. A few hours later it was once again rejected for reason:

"@bitcoinscout, your account is ineligible to participate in the Twitter Ads program at this time based on the Twitter Ads regulated pharmaceutical products, healthcare, and supplements policy."

The data in the app comes form openstreetmaps.org, so technically anyone could add their service that accepts bitcoin be it adult in nature or not. I am surprised they went that far into the app to discover an adult service (or pharmaceutical) accepting bitcoin in their area lol.

Oh well. In the short time I had the ad running it was a terrible cost per action anyway.