# Accessibility bug reports — www.cms.gov, week 2026-W24

41 issue type(s) from 2629 pages scanned. Generated 2026-07-06 by [vital-scans](https://github.com/mgifford/vital-core), following [accessibility bug-reporting best practices](https://mgifford.github.io/ACCESSIBILITY.md/examples/ACCESSIBILITY_BUG_REPORTING_BEST_PRACTICES.html).

> Automated checks find roughly a third of accessibility barriers. Fields marked "requires manual testing" cannot be observed by an automated scan and need a human with assistive technology.

---
## Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8)

**Bug ID:** `VS-e1f7ea68`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `<a href="http://www.hhs.gov">`  
**WCAG SC:** 2.5.8 — Target Size (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r113` ([reference](https://alfa.siteimprove.com/rules/sia-r113))  
**Severity:** Moderate  
**Frequency:** 32 instances; 6 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 6 of 2629 scanned pages (32 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: <a href="http://www.hhs.gov">
3. Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

### Impact
Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%).
- **Limited manipulation/strength** (13.0% of population)
- **Limited reach** (2.0% of population)
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/current-partners
- https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/chain-ownership-system-pecos
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/medicare/medicaid-coordination/states/education
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/current-partners
- https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/chain-ownership-system-pecos

---

## Accessible name of link or button matches visible label (WCAG 2.5.3)

**Bug ID:** `VS-0e9663dd`  
**Pattern ID:** `VS-f7dba940`  
**URL:** http://cms.gov/priorities/innovation/models  
**XPath / selector:** `<button type="button" aria-expanded="false" aria-label="click to display filter options" class="ds-c-button searchBar__mobileFilterToggle__button">`  
**WCAG SC:** 2.5.3 — Label in Name (Level A)  
**Rule:** Siteimprove Alfa — `sia-r14` ([reference](https://alfa.siteimprove.com/rules/sia-r14))  
**Severity:** Moderate  
**Frequency:** 36 instances; 20 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 20 of 2629 scanned pages (36 instances).

### Steps to reproduce
1. Open http://cms.gov/priorities/innovation/models.
2. Locate the element: <button type="button" aria-expanded="false" aria-label="click to display filter options" class="ds-c-button searchBar__mobileFilterToggle__button">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

### Impact
Affects Without vision (1.0%), Without speech (0.5%).
- **Without vision** (1.0% of population)
- **Without speech** (0.5% of population)

### Affected pages
- http://cms.gov/priorities/innovation/models
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=7&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/cal.aspx?calid=140
- http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31
- https://www.cms.gov/medicare-coverage-database/view/cal.aspx?calid=91
- https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=13
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=26&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=46&ncdver=1&sortBy=chapter
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=104
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=3&sortBy=status&status=all
- https://www.cms.gov/medicare/regulations-guidance/physician-self-referral/significant-regulatory-history
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=102&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=82&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/reports/reports.aspx
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=85&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/reports/national-coverage-ncacal-status-report.aspx?ncacaldoctype=all&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=30&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/cal.aspx?bc=17&calid=146&ncacaldoctype=all&sortBy=status&status=all

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14

### Example pages
- http://cms.gov/priorities/innovation/models
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-544f1c21`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `img[src$="cms-site-logo.png"]`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** axe-core — `image-alt` ([reference](https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 11 instances; 11 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<img src="cms-site-logo.png">
```

### Description
Images must have alternative text. Detected by axe-core rule image-alt on 11 of 2629 scanned pages (11 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: img[src$="cms-site-logo.png"]
3. Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0097.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0174.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0023.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0004.html
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0093.html

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-5be66cad`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `<img src="cms-site-logo.png">`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** Siteimprove Alfa — `sia-r2` ([reference](https://alfa.siteimprove.com/rules/sia-r2))  
**Severity:** Moderate  
**Frequency:** 3 instances; 3 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 3 of 2629 scanned pages (3 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: <img src="cms-site-logo.png">
3. Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give every <img> an accessible name (alt text), or alt="" if purely decorative.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html

---

## <ul> and <ol> must only directly contain <li>, <script> or <template> elements (WCAG 1.3.1)

**Bug ID:** `VS-6e9a6724`  
**Pattern ID:** `VS-a0bdbdf6`  
**URL:** https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A46&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC  
**XPath / selector:** `.pager__items`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `list` ([reference](https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 17 instances; 9 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<ul class="pager__items js-pager__items cms-evo-unstyled-list ds-u-display--flex ds-u-justify-content--center">
```

### Description
<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 9 of 2629 scanned pages (17 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A46&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC.
2. Locate the element: .pager__items
3. Confirm the axe-core finding for rule list against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A46&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A196&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A111&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A111&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A81&f%5B2%5D=topic%3A111&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29581&f%5B1%5D=newsroom_article_type%3A29601&f%5B2%5D=topic%3A111&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A111&f%5B2%5D=topic%3A126&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=98&ncdver=2&sortBy=chapter

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Use <ul>/<ol> with only <li> children for lists; don't fake lists with <div>s.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI

### Example pages
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A46&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/newsroom/search?f%5B0%5D=topic%3A196&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
- https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A111&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC

---

## <li> elements must be contained in a <ul> or <ol> (WCAG 1.3.1)

**Bug ID:** `VS-a64dbd18`  
**Pattern ID:** `VS-6175596b`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N  
**XPath / selector:** `td[scope="column"][valign="top"]:nth-child(2) > li:nth-child(12)`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `listitem` ([reference](https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 40 instances; 2 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<li> STS, mitral valve repair, mean (SD) %: 7.4 (5.3)
</li>
```

### Description
<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 2 of 2629 scanned pages (40 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N.
2. Locate the element: td[scope="column"][valign="top"]:nth-child(2) > li:nth-child(12)
3. Confirm the axe-core finding for rule listitem against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** <li> must be inside a <ul> or <ol>.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N

---

## Presentational children of an element are not focusable (WCAG 1.3.1)

**Bug ID:** `VS-1d5bb111`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239  
**XPath / selector:** `<ul class="nav nav-pills flex-column">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r68` ([reference](https://alfa.siteimprove.com/rules/sia-r68))  
**Severity:** Moderate  
**Frequency:** 10 instances; 10 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 10 of 2629 scanned pages (10 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239.
2. Locate the element: <ul class="nav nav-pills flex-column">
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=7&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=26&sortBy=status&status=all
- https://www.cms.gov/medicaid-chip/medicare-coordination/avoidable-hospitalizations
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=3&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=102&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=82&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=85&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/reports/national-coverage-ncacal-status-report.aspx?ncacaldoctype=all&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=30&sortBy=status&status=all

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=7&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=26&sortBy=status&status=all

---

## Element has required owned roles (WCAG 1.3.1)

**Bug ID:** `VS-f9bad6ea`  
**Pattern ID:** `VS-3c632d31`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `<h1>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r64` ([reference](https://alfa.siteimprove.com/rules/sia-r64))  
**Severity:** Moderate  
**Frequency:** 6 instances; 6 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 6 of 2629 scanned pages (6 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: <h1>
3. Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/medicare/quality/nursing-home-improvement/resident-assessment-instrument-manual
- https://www.cms.gov/medicare/quality/nursing-home-improvement/announcements
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/medicare/appeals-grievances/fee-for-service/second-level-appeal

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r64

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/medicare/quality/nursing-home-improvement/resident-assessment-instrument-manual
- https://www.cms.gov/medicare/quality/nursing-home-improvement/announcements

---

## Element in required WAI-ARIA context role (WCAG 1.3.1)

**Bug ID:** `VS-e9582237`  
**Pattern ID:** `VS-0ddc2ac6`  
**URL:** https://www.cms.gov/  
**XPath / selector:** `<button type="button" id="trigger-tabs-1714902645" aria-expanded="false" class="responsive-tabs__tab-button--mobile ds-u-display--flex">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r42` ([reference](https://alfa.siteimprove.com/rules/sia-r42))  
**Severity:** Moderate  
**Frequency:** 5 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Element in required WAI-ARIA context role. Detected by Siteimprove Alfa rule sia-r42 on 1 of 2629 scanned pages (5 instances).

### Steps to reproduce
1. Open https://www.cms.gov/.
2. Locate the element: <button type="button" id="trigger-tabs-1714902645" aria-expanded="false" class="responsive-tabs__tab-button--mobile ds-u-display--flex">
3. Confirm the Siteimprove Alfa finding for rule sia-r42 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r42

---

## Table cell has header (WCAG 1.3.1)

**Bug ID:** `VS-a7955214`  
**Pattern ID:** `VS-3f067795`  
**URL:** https://www.cms.gov/medicare/coverage/determination-process/basics/icd-10  
**XPath / selector:** `<td>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r77` ([reference](https://alfa.siteimprove.com/rules/sia-r77))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 1 of 2629 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/coverage/determination-process/basics/icd-10.
2. Locate the element: <td>
3. Confirm the Siteimprove Alfa finding for rule sia-r77 against WCAG 1.3.1 Info and Relationships.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/medicare/coverage/determination-process/basics/icd-10

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r77

---

## Links must be distinguishable without relying on color (WCAG 1.4.1)

**Bug ID:** `VS-10f76f16`  
**Pattern ID:** `VS-8ade3360`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239  
**XPath / selector:** `#hplTrackingSheet`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** axe-core — `link-in-text-block` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 76 instances; 32 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<a id="hplTrackingSheet" href="/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?ncaid=239" class="document-view-section-text log-click system-link" data-page-action="Clicked the Tracking Sh
```

### Description
Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 32 of 2629 scanned pages (76 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239.
2. Locate the element: #hplTrackingSheet
3. Confirm the axe-core finding for rule link-in-text-block against WCAG 1.4.1 Use of Color.

### Impact
Affects Without color perception (4.5%), Limited vision (2.4%).
- **Without color perception** (4.5% of population)
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=179&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=218
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=7&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=49&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/cal.aspx?bc=17&calid=88&ncacaldoctype=all&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=321&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/cal.aspx?calid=140
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=136&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/cal.aspx?calid=91
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=66
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=215&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=26&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=15&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=199&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=3&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=229&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=230&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=102&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=82&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=35&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/cal.aspx?bc=17&calid=225&ncacaldoctype=all&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=16&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=272&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=315&sortBy=status&status=all

…and more — 32 pages total ([download CSV](csv/axe-core__link-in-text-block.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=179&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=218

---

## Link in text block is visually distinguishable without color (WCAG 1.4.1)

**Bug ID:** `VS-c90c3b86`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://www.cms.gov/newsroom/data  
**XPath / selector:** `<a href="https://data.cms.gov/fact-sheet/cms-fast-facts" data-once="linkMatch">`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** Siteimprove Alfa — `sia-r62` ([reference](https://alfa.siteimprove.com/rules/sia-r62))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 1 of 2629 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/data.
2. Locate the element: <a href="https://data.cms.gov/fact-sheet/cms-fast-facts" data-once="linkMatch">
3. Confirm the Siteimprove Alfa finding for rule sia-r62 against WCAG 1.4.1 Use of Color.

### Impact
Affects Without color perception (4.5%), Limited vision (2.4%).
- **Without color perception** (4.5% of population)
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.cms.gov/newsroom/data

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Make links visually distinguishable from surrounding text (not by color alone).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-2f53e181`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital  
**XPath / selector:** `p:nth-child(2) > a[data-entity-substitution="canonical"][data-entity-type="node"][data-once="linkMatch"]:nth-child(1)`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** axe-core — `link-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 15 instances; 8 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<a href="/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-proposed-rule-home-page" data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="e2075c13
```

### Description
Links must have discernible text. Detected by axe-core rule link-name on 8 of 2629 scanned pages (15 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital.
2. Locate the element: p:nth-child(2) > a[data-entity-substitution="canonical"][data-entity-type="node"][data-once="linkMatch"]:nth-child(1)
3. Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital
- https://www.cms.gov/medicare/medicaid-coordination/about/dsnps
- http://cms.gov/medicare/enrollment-renewal/providers-suppliers/hospitals-center
- https://www.cms.gov/medicare/appeals-grievances/fee-for-service/fourth-level-appeal
- https://www.cms.gov/priorities/burden-reduction/overview/customer-engagement/accountable-care-organization-aco-engagement
- https://www.cms.gov/medicare/medicaid-coordination/about/resources-integrated-care
- https://www.cms.gov/medicare/quality/hospice/cahpsr-hospice-survey
- https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/hospitals-center

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give the link discernible text. Avoid empty links and icon-only links without an aria-label.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI

### Example pages
- https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital
- https://www.cms.gov/medicare/medicaid-coordination/about/dsnps
- http://cms.gov/medicare/enrollment-renewal/providers-suppliers/hospitals-center

---

## Link has accessible name (WCAG 2.4.4)

**Bug ID:** `VS-79af47ed`  
**Pattern ID:** `VS-28ebd979`  
**URL:** https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital  
**XPath / selector:** `<a href="/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-proposed-rule-home-page" data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="e2075c13`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** Siteimprove Alfa — `sia-r11` ([reference](https://alfa.siteimprove.com/rules/sia-r11))  
**Severity:** Moderate  
**Frequency:** 11 instances; 7 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 7 of 2629 scanned pages (11 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital.
2. Locate the element: <a href="/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-proposed-rule-home-page" data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="e2075c13
3. Confirm the Siteimprove Alfa finding for rule sia-r11 against WCAG 2.4.4 Link Purpose (In Context).

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital
- https://www.cms.gov/medicare/medicaid-coordination/about/dsnps
- http://cms.gov/medicare/enrollment-renewal/providers-suppliers/hospitals-center
- https://www.cms.gov/medicare/appeals-grievances/fee-for-service/fourth-level-appeal
- https://www.cms.gov/medicare/medicaid-coordination/about/resources-integrated-care
- https://www.cms.gov/medicare/quality/hospice/cahpsr-hospice-survey
- https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/hospitals-center

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Give the link an accessible name via text content or aria-label.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r11

### Example pages
- https://www.cms.gov/medicare/payment/prospective-payment-systems/long-term-care-hospital
- https://www.cms.gov/medicare/medicaid-coordination/about/dsnps
- http://cms.gov/medicare/enrollment-renewal/providers-suppliers/hospitals-center

---

## <html> element must have a lang attribute (WCAG 3.1.1)

**Bug ID:** `VS-25d8f547`  
**Pattern ID:** `VS-c126b6a6`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `html`  
**WCAG SC:** 3.1.1 — Language of Page (Level A)  
**Rule:** axe-core — `html-has-lang` ([reference](https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 11 instances; 11 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<html>
```

### Description
<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 11 of 2629 scanned pages (11 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: html
3. Confirm the axe-core finding for rule html-has-lang against WCAG 3.1.1 Language of Page.

### Impact
Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0097.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0174.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0023.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0004.html
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0093.html

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Add a lang attribute to <html> (e.g. lang="en").

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html

---

## Document has a valid lang attribute (WCAG 3.1.1)

**Bug ID:** `VS-edb179fb`  
**Pattern ID:** `VS-7a0e5645`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `<html>`  
**WCAG SC:** 3.1.1 — Language of Page (Level A)  
**Rule:** Siteimprove Alfa — `sia-r4` ([reference](https://alfa.siteimprove.com/rules/sia-r4))  
**Severity:** Moderate  
**Frequency:** 3 instances; 3 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 3 of 2629 scanned pages (3 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: <html>
3. Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page.

### Impact
Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Add a valid lang attribute to <html>.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r4

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html

---

## aria-hidden element does not contain focusable elements (WCAG 4.1.2)

**Bug ID:** `VS-960f6639`  
**Pattern ID:** `VS-f6cf30ff`  
**URL:** http://cms.gov/priorities/innovation/models  
**XPath / selector:** `<div id="tooltip-trigger--2" tabindex="-1" class="ds-c-tooltip" data-placement="top">`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** Siteimprove Alfa — `sia-r17` ([reference](https://alfa.siteimprove.com/rules/sia-r17))  
**Severity:** Moderate  
**Frequency:** 3 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
aria-hidden element does not contain focusable elements. Detected by Siteimprove Alfa rule sia-r17 on 1 of 2629 scanned pages (3 instances).

### Steps to reproduce
1. Open http://cms.gov/priorities/innovation/models.
2. Locate the element: <div id="tooltip-trigger--2" tabindex="-1" class="ds-c-tooltip" data-placement="top">
3. Confirm the Siteimprove Alfa finding for rule sia-r17 against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- http://cms.gov/priorities/innovation/models

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r17

---

## Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3)

**Bug ID:** `VS-5ce6d2b9`  
**Pattern ID:** `VS-be8d563e`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N  
**XPath / selector:** `p:nth-child(328) > font`  
**WCAG SC:** 1.4.3 — Contrast (Minimum) (Level AA)  
**Rule:** axe-core — `color-contrast` ([reference](https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 37 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<font color="FF0000">[XXX.X]</font>
```

### Description
Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 1 of 2629 scanned pages (37 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N.
2. Locate the element: p:nth-child(328) > font
3. Confirm the axe-core finding for rule color-contrast against WCAG 1.4.3 Contrast (Minimum).

### Impact
Affects Limited vision (2.4%), Without color perception (4.5%).
- **Limited vision** (2.4% of population)
- **Without color perception** (4.5% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Increase the contrast between text and its background to at least 4.5:1 (3:1 for large text). Check both light and dark modes.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI

---

## Text has sufficient color contrast (Enhanced) (WCAG 1.4.3)

**Bug ID:** `VS-65e58df6`  
**Pattern ID:** `VS-f7e99f4b`  
**URL:** https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events  
**XPath / selector:** `text: "FEB"`  
**WCAG SC:** 1.4.3 — Contrast (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r69` ([reference](https://alfa.siteimprove.com/rules/sia-r69))  
**Severity:** Moderate  
**Frequency:** 28 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 1 of 2629 scanned pages (28 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events.
2. Locate the element: text: "FEB"
3. Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum).

### Impact
Affects Limited vision (2.4%), Without color perception (4.5%).
- **Limited vision** (2.4% of population)
- **Without color perception** (4.5% of population)

### Affected pages
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Increase text contrast to meet WCAG AA (4.5:1, or 3:1 for large text).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r69

---

## Zooming and scaling must not be disabled (WCAG 1.4.4)

**Bug ID:** `VS-13cd516f`  
**Pattern ID:** `VS-6c86a43a`  
**URL:** https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html  
**XPath / selector:** `meta[name="viewport"]`  
**WCAG SC:** 1.4.4 — Resize Text (Level AA)  
**Rule:** axe-core — `meta-viewport` ([reference](https://dequeuniversity.com/rules/axe/4.12/meta-viewport?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<meta name="viewport" content="width=device-width,initial-scale=1,user-scalable=no,shrink-to-fit=no,minimal-ui">
```

### Description
Zooming and scaling must not be disabled. Detected by axe-core rule meta-viewport on 1 of 2629 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html.
2. Locate the element: meta[name="viewport"]
3. Confirm the axe-core finding for rule meta-viewport against WCAG 1.4.4 Resize Text.

### Impact
Affects Limited vision (2.4%).
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Don't disable zoom (user-scalable=no / maximum-scale=1); low-vision users need to zoom.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/meta-viewport?application=axeAPI

---

## lang attribute must have a valid value (WCAG 3.1.2)

**Bug ID:** `VS-8f470a84`  
**Pattern ID:** `VS-dd1c019f`  
**URL:** https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings  
**XPath / selector:** `a[href$="#_ftnref1"] > span[lang="X-NONE"]`  
**WCAG SC:** 3.1.2 — Language of Parts (Level AA)  
**Rule:** axe-core — `valid-lang` ([reference](https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<span lang="X-NONE">[1]</span>
```

### Description
lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 2629 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings.
2. Locate the element: a[href$="#_ftnref1"] > span[lang="X-NONE"]
3. Confirm the axe-core finding for rule valid-lang against WCAG 3.1.2 Language of Parts.

### Impact
Affects Without vision (1.0%), Limited cognitive, language, or learning ability (11.0%).
- **Without vision** (1.0% of population)
- **Limited cognitive, language, or learning ability** (11.0% of population)

### Affected pages
- https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-96a12e61`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter  
**XPath / selector:** `text: "Here's how you know"`  
**WCAG SC:** 1.4.6 — Contrast (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r66` ([reference](https://alfa.siteimprove.com/rules/sia-r66))  
**Severity:** Moderate  
**Frequency:** 87 instances; 19 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 19 of 2629 scanned pages (87 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter.
2. Locate the element: text: "Here's how you know"
3. Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=7&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/cal.aspx?calid=140
- http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31
- https://www.cms.gov/medicare-coverage-database/view/cal.aspx?calid=91
- https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=13
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=26&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=46&ncdver=1&sortBy=chapter
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=104
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=3&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=102&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=82&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/reports/reports.aspx
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=85&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/reports/national-coverage-ncacal-status-report.aspx?ncacaldoctype=all&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=30&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/cal.aspx?bc=17&calid=146&ncacaldoctype=all&sortBy=status&status=all

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Increase text contrast to meet WCAG AAA (7:1).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239

---

## Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8)

**Bug ID:** `VS-b8722a6e`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19  
**XPath / selector:** `<p class="ds-c-usa-banner__header-text">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r73` ([reference](https://alfa.siteimprove.com/rules/sia-r73))  
**Severity:** Moderate  
**Frequency:** 18945 instances; 1178 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 1178 of 2629 scanned pages (18945 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19.
2. Locate the element: <p class="ds-c-usa-banner__header-text">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19
- http://cms.gov/priorities/innovation/models
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index
- https://www.cms.gov/medicare/payment/opioid-treatment-program/enrollment
- https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-payment-rates-addenda
- https://www.cms.gov/medicare/coordination-benefits-recovery/mandatory-insurer-reporting-group-health-plans/training-manual
- https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/swing-bed-providers
- https://www.cms.gov/medicare/payment/medicare-part-b-drug-average-sales-price/asp-events
- https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-regulations-and-notices
- https://www.cms.gov/medicare/payment/fee-for-service-providers/hospital-aquired-conditions-hac
- http://cms.gov/acronyms?page=7
- https://www.cms.gov/regulations-and-guidance/administrative-simplification/versions5010andd0/5010-national-calls-items/cms1254312
- https://www.cms.gov/medicare/coding-billing/integrated-outpatient-code-editor/integrated-outpatient-code-editor-i-oce-software
- https://www.cms.gov/medicare/quality/end-stage-renal-disease-esrd-quality-incentive-program
- http://cms.gov/medicare/physician-fee-schedule/search/overview
- https://www.cms.gov/medicare/enrollment-renewal/part-d-plans/low-income-subsidy
- https://www.cms.gov/medicare/appeals-grievances/ombudsman-center
- https://www.cms.gov/medicare/coverage/prescription-drug-coverage-contracting/hpms-guidance-history
- https://www.cms.gov/medicare/coverage/end-stage-renal-disease-center
- https://www.cms.gov/medicare/coding-billing/medicare-administrative-contractors-macs/macra-section-509
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ipps-regulations-and-notices
- https://www.cms.gov/medicare/payment/fee-schedules/durable-medical-equipment-prosthetic-devices-prosthetics-orthotics-supplies/dmepos-payment-determinations-new-items-services
- https://www.cms.gov/medicare/coverage/evidence/home-oxygen-copd
- https://www.cms.gov/medicare/quality/hospice-quality-reporting-program/how-update-hospice-demographic-data
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2013-transmittals-items/r2261cp

…and more — 1178 pages total ([download CSV](csv/alfa__sia-r73.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73

### Example pages
- https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19
- http://cms.gov/priorities/innovation/models
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index

---

## Link is distinguishable without relying on color (WCAG 1.4.8)

**Bug ID:** `VS-3dc6d2b2`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter  
**XPath / selector:** `<p class="mb-2">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r74` ([reference](https://alfa.siteimprove.com/rules/sia-r74))  
**Severity:** Moderate  
**Frequency:** 548 instances; 20 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 20 of 2629 scanned pages (548 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter.
2. Locate the element: <p class="mb-2">
3. Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=7&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/cal.aspx?calid=140
- http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31
- https://www.cms.gov/medicare-coverage-database/view/cal.aspx?calid=91
- https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=13
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=26&sortBy=status&status=all
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=46&ncdver=1&sortBy=chapter
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=104
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=3&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=102&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=82&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/reports/reports.aspx
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=85&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/reports/national-coverage-ncacal-status-report.aspx?ncacaldoctype=all&status=all
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=30&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/cal.aspx?bc=17&calid=146&ncacaldoctype=all&sortBy=status&status=all

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=103&ncdver=1&sortBy=chapter
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=239
- http://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=7&sortBy=status&status=all

---

## Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5)

**Bug ID:** `VS-fa3b5900`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19  
**XPath / selector:** `<a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">`  
**WCAG SC:** 2.5.5 — Target Size (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r111` ([reference](https://alfa.siteimprove.com/rules/sia-r111))  
**Severity:** Moderate  
**Frequency:** 61216 instances; 1178 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 1178 of 2629 scanned pages (61216 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19.
2. Locate the element: <a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">
3. Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19
- http://cms.gov/priorities/innovation/models
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index
- https://www.cms.gov/medicare/payment/opioid-treatment-program/enrollment
- https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-payment-rates-addenda
- https://www.cms.gov/medicare/coordination-benefits-recovery/mandatory-insurer-reporting-group-health-plans/training-manual
- https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/swing-bed-providers
- https://www.cms.gov/medicare/payment/medicare-part-b-drug-average-sales-price/asp-events
- https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-regulations-and-notices
- https://www.cms.gov/medicare/payment/fee-for-service-providers/hospital-aquired-conditions-hac
- http://cms.gov/acronyms?page=7
- https://www.cms.gov/regulations-and-guidance/administrative-simplification/versions5010andd0/5010-national-calls-items/cms1254312
- https://www.cms.gov/medicare/coding-billing/integrated-outpatient-code-editor/integrated-outpatient-code-editor-i-oce-software
- https://www.cms.gov/medicare/quality/end-stage-renal-disease-esrd-quality-incentive-program
- http://cms.gov/medicare/physician-fee-schedule/search/overview
- https://www.cms.gov/medicare/enrollment-renewal/part-d-plans/low-income-subsidy
- https://www.cms.gov/medicare/appeals-grievances/ombudsman-center
- https://www.cms.gov/medicare/coverage/prescription-drug-coverage-contracting/hpms-guidance-history
- https://www.cms.gov/medicare/coverage/end-stage-renal-disease-center
- https://www.cms.gov/medicare/coding-billing/medicare-administrative-contractors-macs/macra-section-509
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ipps-regulations-and-notices
- https://www.cms.gov/medicare/payment/fee-schedules/durable-medical-equipment-prosthetic-devices-prosthetics-orthotics-supplies/dmepos-payment-determinations-new-items-services
- https://www.cms.gov/medicare/coverage/evidence/home-oxygen-copd
- https://www.cms.gov/medicare/quality/hospice-quality-reporting-program/how-update-hospice-demographic-data
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2013-transmittals-items/r2261cp

…and more — 1178 pages total ([download CSV](csv/alfa__sia-r111.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111

### Example pages
- https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19
- http://cms.gov/priorities/innovation/models
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index

---

## Heading levels should only increase by one (WCAG criterion undetermined)

**Bug ID:** `VS-1d5dece4`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index  
**XPath / selector:** `.rxbodyfield > h3`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 259 instances; 223 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<h3><strong>FY 2027 Geographic Reclassification Deadlines</strong></h3>
```

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 223 of 2629 scanned pages (259 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index.
2. Locate the element: .rxbodyfield > h3
3. Confirm the axe-core finding for rule heading-order.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index
- https://www.cms.gov/About-CMS/Agency-information/History/index
- http://cms.gov/medicare/physician-fee-schedule/search/overview
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities
- https://www.cms.gov/medicare/payment/fee-schedules/durable-medical-equipment-prosthetic-devices-prosthetics-orthotics-supplies/dmepos-payment-determinations-new-items-services
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FJuly_2009_ASP_Pricing_File.zip
- https://www.cms.gov/medicare/coverage/summary-notice
- https://www.cms.gov/medicare/medicaid-coordination/about/quality
- https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/guidance-regulations
- https://www.cms.gov/apps/aha/license.asp?file=%2Ffiles%2Fzip%2FIOCE-MF-Software-Package-V231R0.zip
- https://www.cms.gov/medicare/payment/part-b-drugs/asp-reporting
- https://www.cms.gov/medicare-coverage-database/reports/national-coverage-annual-report.aspx?docType=all&year=2026
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FJuly-2012-NOC-Pricing-File.zip
- https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/application-types-timeline
- https://www.cms.gov/medicare/medicaid-coordination/plans/mmp-audit-programs
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2F2015-October-ASP-Pricing-File.zip
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2FASCPayment%2FDownloads%2F2019-Apr-ASC-Addenda.zip
- https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/comprehensive-error-rate-testing-cert/background
- https://www.cms.gov/medicare/medicaid-coordination/reduce-avoidable-hospitalizations/enhanced-care-coordination-provider-information
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FJAN_2009_NDC_HCPCS_Crosswalk_Files.zip
- https://www.cms.gov/apps/ama/license.asp?file=%2Ffiles%2Fzip%2Flist-codes-effective-january-1-2020-published-december-2-2019
- https://www.cms.gov/medicaid-chip/medicare-coordination/financial-alignment/approved
- https://www.cms.gov/medicare/medicaid-coordination/about
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2FASCPayment%2FDownloads%2F2019-Oct-ASC-Addenda-Corrections.zip
- https://www.cms.gov/derechos-facturas-medicas/conozca-sus-derechos/usando-seguro

…and more — 223 pages total ([download CSV](csv/axe-core__heading-order.csv)).

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI

### Example pages
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index
- https://www.cms.gov/About-CMS/Agency-information/History/index
- http://cms.gov/medicare/physician-fee-schedule/search/overview

---

## Page should contain a level-one heading (WCAG criterion undetermined)

**Bug ID:** `VS-d1c93dbe`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-payment-rates-addenda  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `page-has-heading-one` ([reference](https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 25 instances; 25 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<html lang="en" dir="ltr" class=" js" style="--vw: 12.8px; --vh: 8px;">
```

### Description
Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 25 of 2629 scanned pages (25 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-payment-rates-addenda.
2. Locate the element: html
3. Confirm the axe-core finding for rule page-has-heading-one.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-payment-rates-addenda
- https://www.cms.gov/priorities/crushing-fraud-waste-abuse/overview/cms-idea-challenge-strategies-securing-member-ids
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/security-privacy
- https://www.cms.gov/medicare/quality/cms-national-quality-strategy/meaningful-measures-2-0
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/events
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/current-partners
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/contact-information
- https://www.cms.gov/medicare/payment/opioid-treatment-programs-otp/billing-payment/otp-payment-rates
- https://www.cms.gov/derechos-facturas-medicas/ayuda
- https://www.cms.gov/medicare/medicaid-coordination/states/beneficiaries
- https://www.cms.gov/derechos-facturas-medicas/ayuda/dispute-una-factura
- https://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/medicare/quality/quality-improvement-organizations/family-centered-care
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/become-partner/benefits-membership
- https://www.cms.gov/medicare/medicaid-coordination/states/education
- https://www.cms.gov/medical-bill-rights
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/organizational-structure
- https://www.cms.gov/medicare/medicaid-coordination/states/best-practices-for-state-medicaid-agencies-smas
- https://www.cms.gov/medicare/medicaid-coordination/states/toolkits-for-providers
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/white-papers
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/become-partner
- https://www.cms.gov/medicare/medicaid-coordination/states/benficiary-card-sharing-risks
- https://www.cms.gov/medicare/medicaid-coordination/states

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI

### Example pages
- https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-payment-rates-addenda
- https://www.cms.gov/priorities/crushing-fraud-waste-abuse/overview/cms-idea-challenge-strategies-securing-member-ids
- https://www.cms.gov/medicare/medicaid-coordination/healthcare-fraud-prevention-partnership/about/security-privacy

---

## Document should have one main landmark (WCAG criterion undetermined)

**Bug ID:** `VS-84a32cf6`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-one-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 11 instances; 11 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<html>
```

### Description
Document should have one main landmark. Detected by axe-core rule landmark-one-main on 11 of 2629 scanned pages (11 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: html
3. Confirm the axe-core finding for rule landmark-one-main.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0097.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0174.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0023.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0004.html
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0093.html

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Each page should have exactly one <main> landmark.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html

---

## All page content should be contained by landmarks (WCAG criterion undetermined)

**Bug ID:** `VS-754161a7`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `.arrows > tbody > tr:nth-child(1)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 288 instances; 11 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<tr>
		<td><img src="cms-site-logo.png"></td>
		<td style="text-align:center;"><h1>ICD-10-CM/PCS MS-DRG v38.0 R1 Definitions Manual</h1><h1></h1></td>
		<td></td>
		<td></td>
		<td></td>
	</tr>
```

### Description
All page content should be contained by landmarks. Detected by axe-core rule region on 11 of 2629 scanned pages (288 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: .arrows > tbody > tr:nth-child(1)
3. Confirm the axe-core finding for rule region.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0097.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0174.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0023.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0004.html
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0093.html

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html

---

## scope attribute should be used correctly (WCAG criterion undetermined)

**Bug ID:** `VS-62d7a933`  
**Pattern ID:** `VS-0ba8ce9d`  
**URL:** http://www.cms.gov/medicare-coverage-database/view/technology-assessments.aspx?taid=15  
**XPath / selector:** `tr:nth-child(2) > td[scope="row"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `scope-attr-valid` ([reference](https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 72 instances; 6 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<td valign="top" scope="row"> <p>Koller et al, 2001</p> </td>
```

### Description
scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 6 of 2629 scanned pages (72 instances).

### Steps to reproduce
1. Open http://www.cms.gov/medicare-coverage-database/view/technology-assessments.aspx?taid=15.
2. Locate the element: tr:nth-child(2) > td[scope="row"]
3. Confirm the axe-core finding for rule scope-attr-valid.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- http://www.cms.gov/medicare-coverage-database/view/technology-assessments.aspx?taid=15
- http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31
- http://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=331&ncdver=4
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=104
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=134

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI

### Example pages
- http://www.cms.gov/medicare-coverage-database/view/technology-assessments.aspx?taid=15
- http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31
- http://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=331&ncdver=4

---

## Banner landmark should not be contained in another landmark (WCAG criterion undetermined)

**Bug ID:** `VS-484d58ec`  
**Pattern ID:** `VS-30db094d`  
**URL:** https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Outpatient.html  
**XPath / selector:** `.Header`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-banner-is-top-level` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<header class="Header" style="position: sticky;">
```

### Description
Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 1 of 2629 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Outpatient.html.
2. Locate the element: .Header
3. Confirm the axe-core finding for rule landmark-banner-is-top-level.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Outpatient.html

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Put the banner landmark (<header>) at the top level, not nested inside another landmark.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI

---

## Headings should not be empty (WCAG criterion undetermined)

**Bug ID:** `VS-72302780`  
**Pattern ID:** `VS-0066c67d`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `h1:nth-child(2)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `empty-heading` ([reference](https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 18 instances; 18 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<h1></h1>
```

### Description
Headings should not be empty. Detected by axe-core rule empty-heading on 18 of 2629 scanned pages (18 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: h1:nth-child(2)
3. Confirm the axe-core finding for rule empty-heading.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/priorities/health-equity/minority-health/resource-center/health-care-professionals-researchers/quality-improvement-interventions
- https://www.cms.gov/medicare/quality/nursing-home-improvement/resident-assessment-instrument-manual
- https://www.cms.gov/training-education/partner-outreach-resources/privacy
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html
- https://www.cms.gov/medicare/quality/nursing-home-improvement/announcements
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0097.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0174.html
- https://www.cms.gov/marketplace/about/oversight/other-insurance-protections/prescription-drug-data-collection-rxdc
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0023.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0004.html
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/marketplace/about/health-insurance-marketplace-quality-initiatives
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0093.html
- https://www.cms.gov/medicare/appeals-grievances/fee-for-service/second-level-appeal

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Remove empty headings or give them text. Don't use heading tags for spacing.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/priorities/health-equity/minority-health/resource-center/health-care-professionals-researchers/quality-improvement-interventions

---

## Table header text should not be empty (WCAG criterion undetermined)

**Bug ID:** `VS-0630997b`  
**Pattern ID:** `VS-d69fc059`  
**URL:** https://www.cms.gov/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/application-information  
**XPath / selector:** `th:nth-child(1)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `empty-table-header` ([reference](https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 2 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<th><img src="/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/other-content-types/for-acos-types-and-timeline.png" alt="" data-entity-type="media" data-entity-uuid="9dd5a361-1bdf-40f4-
```

### Description
Table header text should not be empty. Detected by axe-core rule empty-table-header on 1 of 2629 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/application-information.
2. Locate the element: th:nth-child(1)
3. Confirm the axe-core finding for rule empty-table-header.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/application-information

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI

---

## ARIA role should be appropriate for the element (WCAG criterion undetermined)

**Bug ID:** `VS-1b5b8644`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html  
**XPath / selector:** `body`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `aria-allowed-role` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 1 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<body style="background: #072137" class="cs-HTML theme-unified view-desktop is-landscape ff-on ff-drop-in-base ff-multiple-quiz-tracking ff-player-size-option sidebar-left zoom-mode timeline-playing n
```

### Description
ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 1 of 2629 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html.
2. Locate the element: body
3. Confirm the axe-core finding for rule aria-allowed-role.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html

### Testing environment
Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Remove or change the ARIA role — it isn't allowed on this element type.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI

---

## Form field label is visible (WCAG criterion undetermined)

**Bug ID:** `VS-a8c3336e`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r61` ([reference](https://alfa.siteimprove.com/rules/sia-r61))  
**Severity:** Moderate  
**Frequency:** 1175 instances; 1175 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 1175 of 2629 scanned pages (1175 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r61.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19
- http://cms.gov/priorities/innovation/models
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index
- https://www.cms.gov/medicare/payment/opioid-treatment-program/enrollment
- https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-payment-rates-addenda
- https://www.cms.gov/medicare/coordination-benefits-recovery/mandatory-insurer-reporting-group-health-plans/training-manual
- https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/swing-bed-providers
- https://www.cms.gov/medicare/payment/medicare-part-b-drug-average-sales-price/asp-events
- https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-regulations-and-notices
- https://www.cms.gov/medicare/payment/fee-for-service-providers/hospital-aquired-conditions-hac
- http://cms.gov/acronyms?page=7
- https://www.cms.gov/regulations-and-guidance/administrative-simplification/versions5010andd0/5010-national-calls-items/cms1254312
- https://www.cms.gov/medicare/coding-billing/integrated-outpatient-code-editor/integrated-outpatient-code-editor-i-oce-software
- https://www.cms.gov/medicare/quality/end-stage-renal-disease-esrd-quality-incentive-program
- http://cms.gov/medicare/physician-fee-schedule/search/overview
- https://www.cms.gov/medicare/enrollment-renewal/part-d-plans/low-income-subsidy
- https://www.cms.gov/medicare/appeals-grievances/ombudsman-center
- https://www.cms.gov/medicare/coverage/prescription-drug-coverage-contracting/hpms-guidance-history
- https://www.cms.gov/medicare/coverage/end-stage-renal-disease-center
- https://www.cms.gov/medicare/coding-billing/medicare-administrative-contractors-macs/macra-section-509
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ipps-regulations-and-notices
- https://www.cms.gov/medicare/payment/fee-schedules/durable-medical-equipment-prosthetic-devices-prosthetics-orthotics-supplies/dmepos-payment-determinations-new-items-services
- https://www.cms.gov/medicare/coverage/evidence/home-oxygen-copd
- https://www.cms.gov/medicare/quality/hospice-quality-reporting-program/how-update-hospice-demographic-data
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2013-transmittals-items/r2261cp

…and more — 1175 pages total ([download CSV](csv/alfa__sia-r61.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61

### Example pages
- https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19
- http://cms.gov/priorities/innovation/models
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index

---

## Scrolling content can be accessed by keyboard (WCAG criterion undetermined)

**Bug ID:** `VS-5cec57e6`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19  
**XPath / selector:** `text: "Feedback"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 731 instances; 731 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 731 of 2629 scanned pages (731 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19.
2. Locate the element: text: "Feedback"
3. Confirm the Siteimprove Alfa finding for rule sia-r57.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19
- http://cms.gov/priorities/innovation/models
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index
- https://www.cms.gov/medicare/payment/opioid-treatment-program/enrollment
- https://www.cms.gov/medicare/coordination-benefits-recovery/mandatory-insurer-reporting-group-health-plans/training-manual
- https://www.cms.gov/medicare/payment/prospective-payment-systems/skilled-nursing-facility-snf/swing-bed-providers
- https://www.cms.gov/medicare/payment/prospective-payment-systems/ambulatory-surgical-center-asc/asc-regulations-and-notices
- https://www.cms.gov/regulations-and-guidance/administrative-simplification/versions5010andd0/5010-national-calls-items/cms1254312
- https://www.cms.gov/medicare/coding-billing/integrated-outpatient-code-editor/integrated-outpatient-code-editor-i-oce-software
- https://www.cms.gov/medicare/quality/end-stage-renal-disease-esrd-quality-incentive-program
- http://cms.gov/medicare/physician-fee-schedule/search/overview
- https://www.cms.gov/medicare/enrollment-renewal/part-d-plans/low-income-subsidy
- https://www.cms.gov/medicare/appeals-grievances/ombudsman-center
- https://www.cms.gov/medicare/coverage/prescription-drug-coverage-contracting/hpms-guidance-history
- https://www.cms.gov/medicare/coverage/end-stage-renal-disease-center
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ipps-regulations-and-notices
- https://www.cms.gov/medicare/payment/fee-schedules/durable-medical-equipment-prosthetic-devices-prosthetics-orthotics-supplies/dmepos-payment-determinations-new-items-services
- https://www.cms.gov/medicare/quality/hospice-quality-reporting-program/how-update-hospice-demographic-data
- https://www.cms.gov/medicare/regulations-guidance/legislation/freedom-information-act-foia-service-center/how-we-process-your-request
- https://www.cms.gov/medicare/forms-notices/cms-forms-list
- https://www.cms.gov/medicare/payment/prospective-payment-systems/end-stage-renal-disease-esrd/esrd-pps-outlier-services
- https://www.cms.gov/medicare/regulations-guidance/legislation
- https://www.cms.gov/about-cms/what-we-do/emergency-response/how-can-we-help
- https://www.cms.gov/medicare/regulations-guidance/physician-self-referral/physician-owned-hospitals
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2023-transmittals/r12423cp

…and more — 731 pages total ([download CSV](csv/alfa__sia-r57.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57

### Example pages
- https://www.cms.gov/newsroom/press-releases/cms-releases-new-tools-streamline-certification-labs-testing-covid-19
- http://cms.gov/priorities/innovation/models
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-9b5b0cf7`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index  
**XPath / selector:** `<h3>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 162 instances; 128 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 128 of 2629 scanned pages (162 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index.
2. Locate the element: <h3>
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index
- https://www.cms.gov/medicare/coverage/summary-notice
- https://www.cms.gov/medicare/medicaid-coordination/about/quality
- https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/guidance-regulations
- https://www.cms.gov/medicare/payment/part-b-drugs/asp-reporting
- https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/application-types-timeline
- https://www.cms.gov/medicare/medicaid-coordination/plans/mmp-audit-programs
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2F2015-October-ASP-Pricing-File.zip
- https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/comprehensive-error-rate-testing-cert/background
- https://www.cms.gov/medicare/medicaid-coordination/reduce-avoidable-hospitalizations/enhanced-care-coordination-provider-information
- https://www.cms.gov/apps/ama/license.asp?file=%2Ffiles%2Fzip%2Flist-codes-effective-january-1-2020-published-december-2-2019
- https://www.cms.gov/medicaid-chip/medicare-coordination/financial-alignment/approved
- https://www.cms.gov/medicare/medicaid-coordination/about
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2FASCPayment%2FDownloads%2F2019-Oct-ASC-Addenda-Corrections.zip
- https://www.cms.gov/medicaid-chip/medicare-coordination/financial-alignment/va
- https://www.cms.gov/medicare/quality/quality-improvement-programs/end-stage-renal-disease-esrd-network-programs
- https://www.cms.gov/medicare/coverage/prescription-drug-coverage/medicare-glp-1-bridge/information-providers
- https://www.cms.gov/medicaid-chip/medicare-coordination/financial-alignment/state-proposals
- https://www.cms.gov/medicare/payment/prospective-payment-systems/end-stage-renal-disease-esrd/esrd-pps-drug-designation-process
- https://www.cms.gov/medicare/medicaid-coordination/plans/mmp-enrollment
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FFraud-and-Abuse%2FPhysicianSelfReferral%2FDownloads%2F2015-DHS-Addendum.zip
- https://www.cms.gov/medicaid-chip/medicare-coordination/financial-alignment/mn
- https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-procedure-procedure-ptp-edits
- https://www.cms.gov/medicare/payment/covid-19-vaccine-toolkit/medicare-covid-19-vaccine-shot-payment
- https://www.cms.gov/medicare/coverage/prescription-drug-coverage/medicare-glp-1-bridge/information-part-d-plans

…and more — 128 pages total ([download CSV](csv/alfa__sia-r53.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
**How to fix:** Use headings in a logical, non-skipping order.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53

### Example pages
- https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/wage-index
- https://www.cms.gov/medicare/coverage/summary-notice
- https://www.cms.gov/medicare/medicaid-coordination/about/quality

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-84bb4a0b`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `<h1>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r78` ([reference](https://alfa.siteimprove.com/rules/sia-r78))  
**Severity:** Moderate  
**Frequency:** 41 instances; 34 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 34 of 2629 scanned pages (41 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: <h1>
3. Confirm the Siteimprove Alfa finding for rule sia-r78.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/medicare/quality/cms-national-quality-strategy/meaningful-measures-2-0
- https://www.cms.gov/
- https://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/fraudabuseforprofs/stateprogramintegrityreviews
- https://www.cms.gov/medicare/quality/nursing-home-improvement/resident-assessment-instrument-manual
- https://www.cms.gov/medicare/medicaid-coordination/about/dsnps
- https://www.cms.gov/roster-billing
- https://www.cms.gov/medicare/quality/value-based-programs
- https://www.cms.gov/medicare/quality/nursing-home-improvement/announcements
- http://cms.gov/roster-billing
- https://www.cms.gov/medicare/payment/prospective-payment-systems/provider-specific-data-public-use-sas-format
- https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/hospice-center
- https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/clinical-labs-center
- https://www.cms.gov/medicare/coding-billing/place-of-service-codes/code-sets
- https://www.cms.gov/medicare/coding-billing/skilled-nursing-facility-snf-consolidated-billing/2025-part-mac-update
- https://www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/person-family-engagement
- https://www.cms.gov/medicaid-chip/medicare-coordination/financial-alignment/ma
- https://www.cms.gov/medicaid-chip/medicare-coordination/avoidable-hospitalizations
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/medicare/regulations-guidance/physician-self-referral/fraud-and-abuse-waivers
- https://www.cms.gov/medicaid-chip/medicare-coordination/financial-alignment/il
- https://www.cms.gov/medicare/medicaid-coordination/plans/mmp-marketing-information-resources
- https://www.cms.gov/training-education/learn/find-tools-to-help-you-help-others/guidelines-for-effective-writing
- https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system/current-prior-years-level-ii-coding-decisions
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html

…and more — 34 pages total ([download CSV](csv/alfa__sia-r78.csv)).

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- https://www.cms.gov/medicare/quality/cms-national-quality-strategy/meaningful-measures-2-0
- https://www.cms.gov/

---

## Presentational attribute (use CSS) (WCAG criterion undetermined)

**Bug ID:** `VS-ed09c28b`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html  
**XPath / selector:** `img`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 1171 instances; 19 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<img src="bakpg.png" alt="Previous Page [Alt-p]" height="14" width="31" vspace="0" hspace="0" align="bottom" border="0">
```

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 19 of 2629 scanned pages (1171 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html.
2. Locate the element: img
3. Confirm the deprecated-html finding for rule presentational-attr.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- http://www.cms.gov/medicare-coverage-database/view/technology-assessments.aspx?taid=15
- https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=10
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0010.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0006.html
- http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0097.html
- http://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=331&ncdver=4
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0174.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0023.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0004.html
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=104
- https://www.cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0093.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=134

### Testing environment
Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
Not captured by automated scan — requires manual testing.

### Example pages
- https://www.cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0183.html
- http://www.cms.gov/medicare-coverage-database/view/technology-assessments.aspx?taid=15
- https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=10

---

## Duplicate role landmark is labeled (WCAG criterion undetermined)

**Bug ID:** `VS-ebc87fd6`  
**Pattern ID:** `VS-f2542d87`  
**URL:** http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31  
**XPath / selector:** `<pre>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r79` ([reference](https://alfa.siteimprove.com/rules/sia-r79))  
**Severity:** Moderate  
**Frequency:** 3 instances; 3 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### Description
Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 3 of 2629 scanned pages (3 instances).

### Steps to reproduce
1. Open http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31.
2. Locate the element: <pre>
3. Confirm the Siteimprove Alfa finding for rule sia-r79.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31
- https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=13
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=104

### Testing environment
Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r79

### Example pages
- http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=31
- https://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?MCDId=13
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=104

---

## Obsolete <font> element (use CSS) (WCAG criterion undetermined)

**Bug ID:** `VS-ffc9ec0e`  
**Pattern ID:** `VS-91d2294a`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N  
**XPath / selector:** `font`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `font-element`  
**Severity:** Moderate  
**Frequency:** 2 instances; 1 of 2629 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W24 (1 week)

### HTML snippet
```html
<font color="FF0000">[XXX.X]</font>
```

### Description
Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 1 of 2629 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N.
2. Locate the element: font
3. Confirm the deprecated-html finding for rule font-element.

### Impact
Not captured by automated scan — requires manual testing.

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=305&proposed=N

### Testing environment
Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

### Suggested fix
Not captured by automated scan — requires manual testing.