Patient presents with wheelchair dependence, confirmed by functional assessment and medical necessity documentation.  This individual requires a wheelchair for mobility and community ambulation due to significant impairment in their ability to walk independently.  Contributing factors include [Specific diagnosis e.g., paraplegia, multiple sclerosis, post-polio syndrome, severe osteoarthritis, etc.], resulting in [Specific functional limitations e.g., muscle weakness, decreased lower extremity strength, pain, balance deficits, impaired endurance, etc.].  The patient's current level of function necessitates wheelchair use for all transfers and locomotion.  Assessment reveals dependence on [specify type of transfer assistance: mechanical lift, sliding board, assistance of one or two persons].  Evaluation supports the medical necessity for a wheelchair as a durable medical equipment (DME) item.  Plan includes referral to physical therapy and occupational therapy for ongoing assessment, adaptive equipment training, and strengthening exercises to maintain current functional abilities and prevent further decline.  ICD-10 code [Appropriate ICD-10 code based on underlying diagnosis e.g., Z99.81 Dependence on wheelchair,  G82.20 Paraplegia, unspecified, G35 Multiple sclerosis] is documented.  Wheelchair mobility evaluation completed and documented.  Recommendations for specific wheelchair features, including  [mention specific features, e.g.,  lightweight frame, pressure relieving cushion, adjustable footrests, power assist wheels] provided to optimize function, posture, and pressure relief based on patient's individual needs. Ongoing monitoring and reassessment of wheelchair needs will be conducted as part of routine care.