Exam Portion of E/M coding

Just when I think I got it, now I dont! I have been following the Novitas 4x4 rule, when it comes to determining the Exam portion of the medical record. It was my understanding, that the record needs to be 4 body areas, OR 4 ogan systems, but not a combination of both.

For example,

Consititutional = 1

Eyes= 2

Cardiovascular= 3

Gastrointestinal= 4

To me, that would be a DETAILED exam. HOWEVER, say for example you see this in a record....

Constitutional=1

Neck= 0

back=0

Respiratory=1

To me, that would be a EXPANDED PROBLEM FOCUSED exam.

Am I looking at this wrong?

Exam Portion of E/M coding