I am a little confused about 2 systems using the 4x4 rule. If you have 2 things mentioned in the exam concerning the eyes would it be doubled since there is 2 eyes or would it still only count as 2. If using the 4x4 method to determine if the exam is problem focused or detailed is ENT considered one system, for instance if you have 4 things mentioned about the throat and also the ears would you be able to count both of them for the 4x4 or would it only be one since ENT is considered one system.