"Coding around scenes, images, or similar elements that might be pertinent to a rating assignment does not render this content irrelevant from a ratings standpoint. If a publisher wishes to 'edit out' pertinent content from a final product, it must remove the content from the disc altogether. If that is not feasible, the pertinent content must be disclosed to the ESRB during the rating process so it can be taken into account in the assignment of a rating."

Third-party mods that add additional functionality or content to a game—as opposed to unlocking "hidden" content like Hot Coffee—are not covered. So far, the ESRB seems to be at a loss for how to deal with mods, which it believes can "undermine the accuracy of the original rating."

The agonizing over third-party mods is just so much hand-wringing on the part of the ESRB. There's not really anything it can do to stop game mods from coming out, even if they cross the line from M to A. However, the new guidelines and audit of titles released in the last year is a necessary step for the ESRB to take in the wake of the GTA: San Andreas scandal. If the videogame industry wants to continue to self-regulate its content ratings and avoid having the government do it instead, cracking down on "secret" content will help restore the confidence of the people who matter in the ESRB's rating system.

Source=Arstechnica