Elective major surgery with identified risk factor

Hi all,
What constitutes an identified risk factor for MDM? The patient is 90+ years and our provider holds warfarin for an elective major surgery same day. The patient is also on p.r.n morphine by another provider.

Is it important for our provider to document that it is high risk?

Any input is appreciated. 

Thank you,

Barbara Butler, CPC, CPMA, CGSC
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