The NTSC version has a different cover. Are these going to be added as a secondary picture or is it considered a different item?

In comics, if it is a variant cover, you will often see them considered as a different item within the library. For video games, the content may be slightly different from country to country due to censorship laws etc. I've added a few video games to my 'have' collection when the picture is actually a fan creation and not the official one. At first I was hesitant but after I added it to the collection I essentially forget about it but at least know it is recognised as being there. I can't see the image for the US version, but if you think it is better/cooler than the one posted ask Aimee if she can add it to the entry. Alternatively, post a comment to the item directly with a link to the image. (If it's a long URL i.e. from a google search, I'd suggest turning it into a tiny url :D )