Patient presents with indication for transmetatarsal amputation due to [specify underlying cause, e.g., diabetic foot ulcer, peripheral artery disease, gangrene, trauma, infection].  Physical examination reveals [describe findings, e.g.,  extent of tissue necrosis, presence of infection, palpable pulses, sensory deficits].  Diagnostic studies, including [list studies, e.g.,  X-ray, MRI, arteriogram, wound cultures], confirm the diagnosis and demonstrate [specific findings, e.g., osteomyelitis, absent blood flow, extent of soft tissue involvement].  Conservative treatments, such as [list treatments, e.g.,  debridement, wound care, antibiotics, vascular interventions], were attempted but proved unsuccessful in halting the progression of [specify condition, e.g.,  infection, necrosis].  After a thorough discussion of risks and benefits, including the possibility of revision surgery, the patient consented to transmetatarsal amputation.  Procedure will be performed at the [specify level, e.g.,  Lisfranc, Chopart] joint.  Postoperative plan includes [detail plan, e.g.,  pain management, wound care, physical therapy, prosthetic fitting].  Patient education provided on postoperative care, potential complications such as phantom limb pain, infection, delayed healing, and the importance of follow-up appointments.  ICD-10 code [specify code, e.g.,  Z42.8, depending on reason for amputation] and CPT code [specify code, e.g.,  22850-22855, depending on specific procedure] will be used for billing and coding purposes. This transmetatarsal amputation procedure is deemed medically necessary to prevent further complications and improve the patient's quality of life.