www.cms.gov: Accessibility — week 2026-W30

Automated Accessibility Conformance Report (OpenACR): Download ACR. Machine-readable; compatible with GSA OpenACR tooling. Automated tools find ~⅓ of real barriers — supplement with manual AT testing.

Training priorities

Top WCAG success criteria by pages affected this week. Use these to focus team training on the highest-impact issues.

SC	Criterion	Pages	Rules	Notes
1.4.8	WCAG 1.4.8	2220	4	Component inconsistency
2.5.5	WCAG 2.5.5	1709	1
1.3.1	Info and Relationships (semantic structure)	751	8
1.4.1	Use of Color	593	1
1.4.6	WCAG 1.4.6	467	1

Next 10 actions

Clusters are fingerprinted by normalized selector path + rule id + snippet shape. Rank score = (severity weight × pages affected) / distinct components for the rule. This supersedes the template threshold heuristic while still surfacing it as a validation signal.

Design-system alignment (cms-ds / default). No design-system components detected in sampled findings.

Top 10 clustered component fixes for this week.
Cluster	Severity	Pages	Who it affects	How to fix	Evidence	Decision
Form field label is visible · unattributed component Fix one place, resolve ~1691 finding(s) on 1691 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	1691	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~787 finding(s) on 787 page(s). XPath / selector: `text: "Feedback"`	Moderate	787	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
<html> element must have a lang attribute · unattributed component Fix one place, resolve ~58 finding(s) on 58 page(s). XPath / selector: `html` `<html>`	Serious	58	Without vision, Limited cognitive, language, or learning ability	Add a lang attribute to <html> (e.g. lang="en").	pages (CSV)	Decision Assigned to Notes
Document should have one main landmark · unattributed component Fix one place, resolve ~61 finding(s) on 61 page(s). XPath / selector: `html` `<html>`	Moderate	61	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~464 finding(s) on 464 page(s). XPath / selector: `<a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">`	Moderate	464	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Form elements must have labels · unattributed component Fix one place, resolve ~26 finding(s) on 26 page(s). XPath / selector: `#q` `<input type="text" name="q" id="q" value="Search now" size="10" maxlength="50" class="srchbox" onfocus="this.value='';">`	Critical	26	Without vision, Limited vision, Limited manipulation/strength	Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~427 finding(s) on 427 page(s). XPath / selector: `<a href="#" data-bs-toggle="collapse" id="aCollapseNavigation" aria-label="Collapse Document Navigation">`	Moderate	427	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Page should contain a level-one heading · unattributed component Fix one place, resolve ~39 finding(s) on 39 page(s). XPath / selector: `html` `<html>`	Moderate	39	Requires manual testing.	See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI	pages (CSV)	Decision Assigned to Notes
Images must have alternative text · unattributed component Fix one place, resolve ~32 finding(s) on 32 page(s). XPath / selector: `img[src$="cms-site-logo.png"]` `<img src="cms-site-logo.png">`	Critical	32	Without vision, Limited vision, Limited cognitive, language, or learning ability	Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.	pages (CSV)	Decision Assigned to Notes
Text has minimum contrast ratio of 4.5:1 · unattributed component Fix one place, resolve ~1227 finding(s) on 1227 page(s). XPath / selector: `<p class="ds-c-usa-banner__header-text">`	Moderate	1227	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73	pages (CSV)	Decision Assigned to Notes

Bug reports

9 issue type(s) are shown by default out of 30 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 2 critical, 6 serious, 21 moderate, 1 minor. By WCAG category: 12 WCAG 2.0 A, 2 WCAG 2.0 AA, 1 WCAG 2.2 AA, 2 WCAG 2.x AAA, 7 Best Practice, 6 Undetermined. Ordered by severity, key-page impact, WCAG level, and prevalence. Following accessibility bug-reporting best practices. Download: Markdown · JSON (full archive) · JSON (AI diagnostic) · CSV (all findings) · Priority pages CSV · Priority pages JSON.

Automated testing does not establish full WCAG conformance. Findings in the verification lane require manual testing before they are treated as confirmed failures.

Default view shows 9 prioritized issue type(s); 21 more are available if you switch to "Show everything".

2 finding(s) marked "possible duplicate" — Alfa and axe-core both flagged the same WCAG SC on overlapping pages. If they target the same element, the axe-core report is authoritative. Filter the CSV by possible_duplicate_of to see these. Two engines flagging the same barrier reduces the chance of a false positive.

Findings needing review

These findings need manual verification before they can be treated as confirmed failures. Obligation remains visible for each finding.

Serious axe html-has-lang WCAG 2.0 A <html> element must have a lang attribute (WCAG 3.1.1) 58/7180 pages · 58 instances Likely template

Bug ID: VS-92c51a24
Pattern ID: VS-c126b6a6
Combined ID: VS-92c51a24 (pattern VS-c126b6a6) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: axe-core — <html> element must have a lang attribute [html-has-lang]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 58 of 7180 scanned pages (58 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html.
Locate the element: html
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

…and more — all 58 pages (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: Add a lang attribute to <html> (e.g. lang="en").

Drupal tip: Drupal sets the page lang attribute from Admin › Configuration › Regional and Language › Languages. Ensure the default language is configured.

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

Triage status Notes

Critical axe label WCAG 2.0 A Form elements must have labels (WCAG 4.1.2) 26/7180 pages · 26 instances Likely template

Bug ID: VS-b8193fea
Pattern ID: VS-fafffee0
Combined ID: VS-b8193fea (pattern VS-fafffee0) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Form elements must have labels [label]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html
XPath / selector: #q
History: first seen 2026-W26, last seen 2026-W30 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<input type="text" name="q" id="q" value="Search now" size="10" maxlength="50" class="srchbox" onfocus="this.value='';">

Description

Form elements must have labels. Detected by axe-core rule label on 26 of 7180 scanned pages (26 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html.
Locate the element: #q
Confirm the axe-core finding for rule label 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

…and more — all 26 pages (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: Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.

Drupal tip: Use Drupal's form element "Label" setting. In Webform, every element has a Label field — ensure it's not empty or hidden. Check that twig templates don't strip <label> elements from form fields.

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

Triage status Notes

Critical axe image-alt WCAG 2.0 A Images must have alternative text (WCAG 1.1.1) 24/7180 pages · 32 instances Likely template

Bug ID: VS-b9bf37b0
Pattern ID: VS-9074b4dd
Combined ID: VS-b9bf37b0 (pattern VS-9074b4dd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: axe-core — Images must have alternative text [image-alt]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html
XPath / selector: img[src$="cms-site-logo.png"]
History: first seen 2026-W24, last seen 2026-W30 (6 wk)

HTML snippet — use this to validate the finding without re-running the tool

<img src="cms-site-logo.png">

Description

Images must have alternative text. Detected by axe-core rule image-alt on 33 of 7180 scanned pages (33 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html.
Locate the element: img[src$="cms-site-logo.png"]
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

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.

Drupal tip: In Drupal's Media Library, fill the "Alternative text" field when uploading or editing an image. For images in body fields, the CKEditor "Image Properties" dialog includes an Alt Text field.

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

Triage status Notes

Serious axe list WCAG 2.0 A <ul> and <ol> must only directly contain <li>, <script> or <template> elements (WCAG 1.3.1) 7/7180 pages · 633 instances Likely template

Bug ID: VS-6f7f611b
Pattern ID: VS-a0bdbdf6
Combined ID: VS-6f7f611b (pattern VS-a0bdbdf6) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — <ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]
Example URL: https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A141&items_per_page=10&page=2&sort_by=search_api_relevance&sort_order=DESC
XPath / selector: .pager__items
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<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 569 of 7180 scanned pages (2262 instances).

Steps to reproduce

Open https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A141&items_per_page=10&page=2&sort_by=search_api_relevance&sort_order=DESC.
Locate the element: .pager__items
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

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

Triage status Notes

Serious axe td-headers-attr WCAG 2.0 A Table cell headers attributes must refer to other <th> elements in the same tabl (WCAG 1.3.1) 3/7180 pages · 3 instances

Bug ID: VS-bd919a2a
Pattern ID: VS-07ba3b17
Combined ID: VS-bd919a2a (pattern VS-07ba3b17) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — Table cell headers attributes must refer to other <th> elements in the same tabl [td-headers-attr]
Example URL: https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_issue_date&page=2&sort=asc
XPath / selector: .MsoTableGrid
History: first seen 2026-W25, last seen 2026-W30 (6 wk)

HTML snippet — use this to validate the finding without re-running the tool

<table class="MsoTableGrid">

Description

Table cell headers attributes must refer to other <th> elements in the same tabl. Detected by axe-core rule td-headers-attr on 3 of 7180 scanned pages (3 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_issue_date&page=2&sort=asc.
Locate the element: .MsoTableGrid
Confirm the axe-core finding for rule td-headers-attr 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

Testing environment

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

Suggested fix

How to fix: Associate data cells with their headers correctly using headers/id or scope.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/td-headers-attr?application=axeAPI

Triage status Notes

Serious axe link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 2/7180 pages · 3 instances Likely content

Bug ID: VS-b284c492
Pattern ID: VS-e9fe47ac
Combined ID: VS-b284c492 (pattern VS-e9fe47ac) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: axe-core — Links must have discernible text [link-name]
Example URL: https://cms.gov/newsroom/press-releases/trump-administration-finalizes-transformative-medicare-payment-changes-support-innovation-kidney
XPath / selector: span > a[data-once="linkMatch"]:nth-child(4)
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a href="http://link.email.dy..." data-once="linkMatch">

Description

Links must have discernible text. Detected by axe-core rule link-name on 2 of 7180 scanned pages (3 instances).

Steps to reproduce

Open https://cms.gov/newsroom/press-releases/trump-administration-finalizes-transformative-medicare-payment-changes-support-innovation-kidney.
Locate the element: span > a[data-once="linkMatch"]:nth-child(4)
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

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.

Drupal tip: "Read more" links from Drupal Views should use the "Link text" rewrite field to add context, or add aria-label via the Views rewrite output.

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

Triage status Notes

Serious axe valid-lang WCAG 2.0 AA lang attribute must have a valid value (WCAG 3.1.2) 1/7180 pages · 1 instances Likely content

Bug ID: VS-8f470a84
Pattern ID: VS-dd1c019f
Combined ID: VS-8f470a84 (pattern VS-dd1c019f) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 3.1.2 Language of Parts (Level AA, WCAG 2.0)
Rule: axe-core — lang attribute must have a valid value [valid-lang]
Example 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"]
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<span lang="X-NONE">[1]</span>

Description

lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 7180 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings.
Locate the element: a[href$="#_ftnref1"] > span[lang="X-NONE"]
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

/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

Triage status Notes

Serious axe accesskeys Best Practice accesskey attribute value should be unique (WCAG criterion undetermined) 4/7180 pages · 10 instances

Bug ID: VS-9d00d38d
Pattern ID: VS-bd13f00a
Combined ID: VS-9d00d38d (pattern VS-bd13f00a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — accesskey attribute value should be unique [accesskeys]
Example URL: https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0013.html
XPath / selector: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0012.html"]
History: first seen 2026-W25, last seen 2026-W30 (4 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a accesskey="p" id="prev_page" href="P0012.html"><img src="bakpg.png" alt="Previous Page [Alt-p]" height="14" width="31" vspace="0" hspace="0" align="bottom" border="0"></a>

Description

accesskey attribute value should be unique. Detected by axe-core rule accesskeys on 4 of 7180 scanned pages (10 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0013.html.
Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0012.html"]
Confirm the axe-core finding for rule accesskeys.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

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/accesskeys?application=axeAPI

Triage status Notes

Moderate alfa sia-r4 WCAG 2.0 A Document has a valid lang attribute (WCAG 3.1.1) 18/7180 pages · 18 instances Likely template

Bug ID: VS-9cac4c0f
Pattern ID: VS-7a0e5645
Combined ID: VS-9cac4c0f (pattern VS-7a0e5645) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Document has a valid lang attribute [sia-r4]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html
XPath / selector: <html>
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

Description

Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 18 of 7180 scanned pages (18 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html.
Locate the element: <html>
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

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

Triage status Notes

Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 787/7180 pages · 787 instances Likely template

Bug ID: VS-91b8e58c
Pattern ID: VS-c18be945
Combined ID: VS-91b8e58c (pattern VS-c18be945) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Scrolling content can be accessed by keyboard [sia-r57]
Example URL: https://cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A71&f%5B2%5D=topic%3A81&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
XPath / selector: text: "Feedback"
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 787 of 7180 scanned pages (787 instances).

Steps to reproduce

Open https://cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A71&f%5B2%5D=topic%3A81&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC.
Locate the element: text: "Feedback"
Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 787 pages (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

Triage status Notes

Moderate axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 61/7180 pages · 1445 instances Likely template

Bug ID: VS-c81eb184
Pattern ID: VS-f18df681
Combined ID: VS-c81eb184 (pattern VS-f18df681) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — All page content should be contained by landmarks [region]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html
XPath / selector: .arrows > tbody > tr:nth-child(1)
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<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 61 of 7180 scanned pages (1445 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html.
Locate the element: .arrows > tbody > tr:nth-child(1)
Confirm the axe-core finding for rule region.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 61 pages (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: Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.

Drupal tip: Use Drupal's region system (header, navigation, main, sidebar, footer) and map each to an HTML5 landmark element in your theme's page.html.twig.

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

Triage status Notes

Moderate axe landmark-one-main Best Practice Document should have one main landmark (WCAG criterion undetermined) 61/7180 pages · 61 instances Likely template

Bug ID: VS-4a80b9b5
Pattern ID: VS-d5d82446
Combined ID: VS-4a80b9b5 (pattern VS-d5d82446) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should have one main landmark [landmark-one-main]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

Document should have one main landmark. Detected by axe-core rule landmark-one-main on 61 of 7180 scanned pages (61 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html.
Locate the element: html
Confirm the axe-core finding for rule landmark-one-main.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 61 pages (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: Each page should have exactly one <main> landmark.

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

Triage status Notes

Moderate axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 39/7180 pages · 39 instances Likely template

Bug ID: VS-11a43c3c
Pattern ID: VS-fa44f293
Combined ID: VS-11a43c3c (pattern VS-fa44f293) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Page should contain a level-one heading [page-has-heading-one]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html>

Description

Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 39 of 7180 scanned pages (39 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html.
Locate the element: html
Confirm the axe-core finding for rule page-has-heading-one.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 39 pages (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/page-has-heading-one?application=axeAPI

Triage status Notes

Minor axe empty-heading Best Practice Headings should not be empty (WCAG criterion undetermined) 24/7180 pages · 39 instances Likely template

Bug ID: VS-3a6f28dd
Pattern ID: VS-0066c67d
Combined ID: VS-3a6f28dd (pattern VS-0066c67d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Headings should not be empty [empty-heading]
Example URL: https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html
XPath / selector: h1:nth-child(2)
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h1></h1>

Description

Headings should not be empty. Detected by axe-core rule empty-heading on 41 of 7180 scanned pages (41 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html.
Locate the element: h1:nth-child(2)
Confirm the axe-core finding for rule empty-heading.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

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

Triage status Notes

Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 15/7180 pages · 221 instances Likely template

Bug ID: VS-4bdae545
Pattern ID: VS-d25f622d
Combined ID: VS-4bdae545 (pattern VS-d25f622d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Heading levels should only increase by one [heading-order]
Example URL: http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37022&lcdStatus=all&sortBy=title
XPath / selector: #navStickyHeader
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">Report Information</h3>

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 360 of 7180 scanned pages (369 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37022&lcdStatus=all&sortBy=title.
Locate the element: #navStickyHeader
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

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.

Drupal tip: Drupal Views and blocks can insert headings at arbitrary levels. In the Views UI, set "Title tag" for each display. For block titles, configure the heading level in the block's layout settings.

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

Triage status Notes

Moderate alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 14/7180 pages · 36917 instances Likely template

Bug ID: VS-10977299
Pattern ID: VS-cb53cc4d
Combined ID: VS-10977299 (pattern VS-cb53cc4d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 2.5.5 Target Size (Enhanced) (Level AAA, WCAG 2.1)
Rule: Siteimprove Alfa — Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]
Example URL: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34538&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
XPath / selector: <a href="#h3IssueHeader" data-href="h3IssueHeader" class="nav-link toc-link no-link log-click" title="Jump to Issue">
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 1709 of 7180 scanned pages (65923 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34538&lcdStatus=all&sortBy=title&stateRegion=all&ver=20.
Locate the element: <a href="#h3IssueHeader" data-href="h3IssueHeader" class="nav-link toc-link no-link log-click" title="Jump to Issue">
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

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

Triage status Notes

Moderate alfa sia-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 14/7180 pages · 8943 instances Likely template

Bug ID: VS-b3a107a9
Pattern ID: VS-2208081b
Combined ID: VS-b3a107a9 (pattern VS-2208081b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has minimum contrast ratio of 4.5:1 [sia-r73]
Example URL: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34538&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
XPath / selector: <p class="usa-banner__header-text">
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 1703 of 7180 scanned pages (15970 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34538&lcdStatus=all&sortBy=title&stateRegion=all&ver=20.
Locate the element: <p class="usa-banner__header-text">
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

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

Triage status Notes

Moderate alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 14/7180 pages · 947 instances Likely template

Bug ID: VS-18135954
Pattern ID: VS-7118fead
Combined ID: VS-18135954 (pattern VS-7118fead) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field label is visible [sia-r61]
Example URL: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34538&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 1691 of 7180 scanned pages (1691 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34538&lcdStatus=all&sortBy=title&stateRegion=all&ver=20.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r61.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

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

Triage status Notes

Moderate alfa sia-r75 Undetermined Form field error is identified and described (WCAG criterion undetermined) 11/7180 pages · 22 instances Likely template

Bug ID: VS-f02413d5
Pattern ID: VS-e43903a1
Combined ID: VS-f02413d5 (pattern VS-e43903a1) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field error is identified and described [sia-r75]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html
XPath / selector: <ul id="globar">
History: first seen 2026-W26, last seen 2026-W30 (5 wk)

Description

Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 11 of 7180 scanned pages (22 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html.
Locate the element: <ul id="globar">
Confirm the Siteimprove Alfa finding for rule sia-r75.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

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-r75

Triage status Notes

Moderate alfa sia-r59 Undetermined Element with orientation is not locked (WCAG criterion undetermined) 11/7180 pages · 11 instances Likely template

Bug ID: VS-7c13abb8
Pattern ID: VS-7fbb8b20
Combined ID: VS-7c13abb8 (pattern VS-7fbb8b20) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Element with orientation is not locked [sia-r59]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html
XPath / selector: {"type":"document","children":[{"type":"element","children":[{"type":"element","
History: first seen 2026-W26, last seen 2026-W30 (5 wk)

Description

Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 11 of 7180 scanned pages (11 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html.
Locate the element: {"type":"document","children":[{"type":"element","children":[{"type":"element","
Confirm the Siteimprove Alfa finding for rule sia-r59.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

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-r59

Triage status Notes

Moderate alfa sia-r64 WCAG 2.0 A Element has required owned roles (WCAG 1.3.1) 9/7180 pages · 9 instances Likely template

Bug ID: VS-84c9490d
Pattern ID: VS-3c632d31
Combined ID: VS-84c9490d (pattern VS-3c632d31) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Element has required owned roles [sia-r64]
Example URL: https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0115.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 10 of 7180 scanned pages (10 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0115.html.
Locate the element: <h1>
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

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

Triage status Notes

Moderate deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 7/7180 pages · 485 instances Likely template

Bug ID: VS-d46940dc
Pattern ID: VS-04a9d28c
Combined ID: VS-d46940dc (pattern VS-04a9d28c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: deprecated-html — Presentational attribute (use CSS) [presentational-attr]
Example URL: http://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=42&sortBy=meetingdate&year=all
XPath / selector: div
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

HTML snippet — use this to validate the finding without re-running the tool

<div align="center"><strong>Agenda<br>
Medicare Evidence Development &amp; Coverage Advisory Committee<br>
April 30, 2008<br>
8:00 AM - 4:30 PM<br>
CMS Auditorium</strong></div>

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 29 of 7180 scanned pages (1731 instances).

Steps to reproduce

Open http://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=42&sortBy=meetingdate&year=all.
Locate the element: div
Confirm the deprecated-html finding for rule presentational-attr.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

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.

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 7/7180 pages · 7 instances

Bug ID: VS-cddc5943
Pattern ID: VS-a24eaa8c
Combined ID: VS-cddc5943 (pattern VS-a24eaa8c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Image has accessible name [sia-r2]
Example URL: https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0115.html
XPath / selector: <img src="cms-site-logo.png">
History: first seen 2026-W24, last seen 2026-W30 (6 wk)

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 8 of 7180 scanned pages (8 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0115.html.
Locate the element: <img src="cms-site-logo.png">
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

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

Triage status Notes

Moderate alfa sia-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 3/7180 pages · 41 instances Likely template

Bug ID: VS-e7edc668
Pattern ID: VS-179ad9b3
Combined ID: VS-e7edc668 (pattern VS-179ad9b3) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.2 AA
Obligation: required
Handling: review
WCAG SC: 2.5.8 Target Size (Minimum) (Level AA, WCAG 2.2)
Rule: Siteimprove Alfa — Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]
Example URL: http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56910&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=9
XPath / selector: <a href="#h3HcpcsCodesHeader" data-href="h3HcpcsCodesHeader" class="nav-link toc-link no-link log-click" title="Jump to CPT/HCPCS Codes">
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 176 of 7180 scanned pages (339 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56910&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=9.
Locate the element: <a href="#h3HcpcsCodesHeader" data-href="h3HcpcsCodesHeader" class="nav-link toc-link no-link log-click" title="Jump to CPT/HCPCS Codes">
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

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

Triage status Notes

Moderate alfa sia-r69 WCAG 2.0 AA Text has sufficient color contrast (Enhanced) (WCAG 1.4.3) 3/7180 pages · 12 instances

Bug ID: VS-90b59b61
Pattern ID: VS-f7e99f4b
Combined ID: VS-90b59b61 (pattern VS-f7e99f4b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.3 Contrast (Minimum) (Level AA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has sufficient color contrast (Enhanced) [sia-r69]
Example URL: https://cms.gov/priorities/innovation/innovation-models/vbid
XPath / selector: text: "Health Plan Models"
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

Description

Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 9 of 7180 scanned pages (37 instances).

Steps to reproduce

Open https://cms.gov/priorities/innovation/innovation-models/vbid.
Locate the element: text: "Health Plan Models"
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

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

Triage status Notes

Moderate axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 3/7180 pages · 3 instances

Bug ID: VS-32ccc20b
Pattern ID: VS-8806389c
Combined ID: VS-32ccc20b (pattern VS-8806389c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Landmarks should have a unique role or role/label/title (i.e. accessible name) c [landmark-unique]
Example URL: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-11-10.html
XPath / selector: .views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)
History: first seen 2026-W25, last seen 2026-W30 (6 wk)

HTML snippet — use this to validate the finding without re-running the tool

<span class="views-field views-field-field-topic" role="region" aria-label="Related search topics">
<a href="/newsroom/search?sort_by=search_api_relevance&amp;sort_order=DESC&amp;items_per_page=10&amp

Description

Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 3 of 7180 scanned pages (3 instances).

Steps to reproduce

Open https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-11-10.html.
Locate the element: .views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)
Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

How to fix: When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. "Primary" and "Footer" navigation) so screen-reader users can tell them apart.

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

Triage status Notes

Moderate alfa sia-r53 Undetermined Headings are structured hierarchically (WCAG criterion undetermined) 2/7180 pages · 38 instances Likely template

Bug ID: VS-959f62e1
Pattern ID: VS-f054f4a4
Combined ID: VS-959f62e1 (pattern VS-f054f4a4) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Headings are structured hierarchically [sia-r53]
Example URL: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34538&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
XPath / selector: <h3 id="h3DocumentInformationHeader" class="document-view-section-header">
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 474 of 7180 scanned pages (476 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34538&lcdStatus=all&sortBy=title&stateRegion=all&ver=20.
Locate the element: <h3 id="h3DocumentInformationHeader" class="document-view-section-header">
Confirm the Siteimprove Alfa finding for rule sia-r53.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

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

Triage status Notes

Moderate alfa sia-r45 WCAG 2.0 A aria-hidden element is not exposed to assistive technology (WCAG 1.3.1) 1/7180 pages · 21 instances · possible duplicate Likely content

Bug ID: VS-a366b045
Pattern ID: VS-9207ed51
Combined ID: VS-a366b045 (pattern VS-9207ed51) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — aria-hidden element is not exposed to assistive technology [sia-r45]
Example URL: https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=8&sort=desc
XPath / selector: @headers="view-field-dyna-pe-number-table-column"
History: first seen 2026-W26, last seen 2026-W30 (4 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-aecfe775 (pattern VS-6175596b). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

aria-hidden element is not exposed to assistive technology. Detected by Siteimprove Alfa rule sia-r45 on 1 of 7180 scanned pages (21 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_pe_number&page=8&sort=desc.
Locate the element: @headers="view-field-dyna-pe-number-table-column"
Confirm the Siteimprove Alfa finding for rule sia-r45 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

/medicare/regulations-guidance/transmittals/2022-transmittals

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-r45

Triage status Notes

Moderate alfa sia-r68 WCAG 2.0 A Presentational children of an element are not focusable (WCAG 1.3.1) 1/7180 pages · 15 instances Likely template

Bug ID: VS-e8ff8e55
Pattern ID: VS-d6097011
Combined ID: VS-e8ff8e55 (pattern VS-d6097011) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Presentational children of an element are not focusable [sia-r68]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=40255&proposedStatus=all&sortBy=title
XPath / selector: <tfoot>
History: first seen 2026-W24, last seen 2026-W30 (7 wk)

Description

Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 106 of 7180 scanned pages (381 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=40255&proposedStatus=all&sortBy=title.
Locate the element: <tfoot>
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

/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0013.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-r68

Triage status Notes

Moderate alfa sia-r11 WCAG 2.0 A Link has accessible name (WCAG 2.4.4) 1/7180 pages · 2 instances · possible duplicate Likely content

Bug ID: VS-65ff71a0
Pattern ID: VS-28ebd979
Combined ID: VS-65ff71a0 (pattern VS-28ebd979) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Link has accessible name [sia-r11]
Example URL: https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
XPath / selector: <a href="/files/document/clia-cert-quick-start-guide.pdf" data-entity-substitution="canonical" data-entity-type="media" data-entity-uuid="27ce5119-858b-44f2-bbc6-c5d2d56ce4f0">
History: first seen 2026-W24, last seen 2026-W30 (7 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-b284c492 (pattern VS-e9fe47ac). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 7180 scanned pages (2 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments.
Locate the element: <a href="/files/document/clia-cert-quick-start-guide.pdf" data-entity-substitution="canonical" data-entity-type="media" data-entity-uuid="27ce5119-858b-44f2-bbc6-c5d2d56ce4f0">
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

/medicare/quality/clinical-laboratory-improvement-amendments

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

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (20 rule type(s))

Each failing rule links out to the axe-core documentation. For full element-level detail including HTML snippets and XPaths, see the bug reports above.

axe-core rules failing in 2026-W30, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Links must be distinguishable without relying on color [link-in-text-block]	serious	593	1279	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 593 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	569	2262	/newsroom/search /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 569 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	360	369	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/reports/local-coverage-proposed-lcds-contractor-report.aspx /newsroom/search	all 360 pages (CSV)
All page content should be contained by landmarks [region]	moderate	61	1445	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html /icd10m/version33-fullcode-cms/fullcode_cms/P1572.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0118.html	all 61 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	61	61	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html /icd10m/version33-fullcode-cms/fullcode_cms/P1572.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0118.html	all 61 pages (CSV)
<html> element must have a lang attribute [html-has-lang]	serious	58	58	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html /icd10m/version33-fullcode-cms/fullcode_cms/P1572.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0118.html	all 58 pages (CSV)
Headings should not be empty [empty-heading]	minor	41	41	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0118.html /icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0322.html	all 41 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	39	39	/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html /icd10m/version33-fullcode-cms/fullcode_cms/P0328.html /icd10m/version33-fullcode-cms/fullcode_cms/P0655.html	all 39 pages (CSV)
Images must have alternative text [image-alt]	critical	33	33	/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0323.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0118.html /icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0322.html	all 33 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	30	286	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx	all 30 pages (CSV)
Form elements must have labels [label]	critical	26	26	/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html /icd10m/version33-fullcode-cms/fullcode_cms/P0328.html /icd10m/version33-fullcode-cms/fullcode_cms/P0655.html	all 26 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	20	484	/medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 20 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	11	17	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 11 pages (CSV)
accesskey attribute value should be unique [accesskeys]	serious	4	10	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0013.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0246.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0001.html	all 4 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	3	3	/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-11-10.html /about-cms/contact/newsroom /apps/media/press_releases.asp	all 3 pages (CSV)
Table cell headers attributes must refer to other <th> elements in the same table [td-headers-attr]	serious	3	3	/medicare/regulations-guidance/transmittals/2022-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals	all 3 pages (CSV)
<li> elements must be contained in a <ul> or <ol> [listitem]	serious	2	6	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 2 pages (CSV)
Links must have discernible text [link-name]	serious	2	3	/newsroom/press-releases/trump-administration-finalizes-transformative-medicare-payment-changes-support-innovation-kidney /medicare/quality/clinical-laboratory-improvement-amendments	all 2 pages (CSV)
Scrollable region must have keyboard access [scrollable-region-focusable]	serious	2	2	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 2 pages (CSV)
lang attribute must have a valid value [valid-lang]	serious	1	1	/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (26 rule type(s))

Rule-level summary from Siteimprove Alfa (W3C ACT-based). Findings that overlap with axe-core on the same WCAG success criterion are noted as possible duplicates in the bug reports above.

Alfa rules failing in 2026-W30, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	1709	65923	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /newsroom/search	all 1709 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	1703	15970	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /newsroom/search	all 1703 pages (CSV)
Form field label is visible [sia-r61]	n/a	1691	1691	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /newsroom/search	all 1691 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	787	787	/newsroom/search /newsroom/search /glossary	all 787 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	474	476	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 474 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	467	2704	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 467 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	465	32158	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 465 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	464	1185	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 464 pages (CSV)
Table header has scope [sia-r78]	n/a	196	283	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 196 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	176	339	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 176 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	106	381	/medicare-coverage-database/reports/local-coverage-proposed-lcds-contractor-report.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 106 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	58	90	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 58 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	34	399	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 34 pages (CSV)
iframe element is not empty [sia-r71]	n/a	18	188	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 18 pages (CSV)
Document has a valid lang attribute [sia-r4]	n/a	18	18	/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html /icd10m/version33-fullcode-cms/fullcode_cms/P0328.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0115.html	all 18 pages (CSV)
Form field error is identified and described [sia-r75]	n/a	11	22	/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html /icd10m/version33-fullcode-cms/fullcode_cms/P0328.html /icd10m/version33-fullcode-cms/fullcode_cms/P1515.html	all 11 pages (CSV)
Element with orientation is not locked [sia-r59]	n/a	11	11	/icd10m/version33-fullcode-cms/fullcode_cms/P1572.html /icd10m/version33-fullcode-cms/fullcode_cms/P0328.html /icd10m/version33-fullcode-cms/fullcode_cms/P1515.html	all 11 pages (CSV)
Element has required owned roles [sia-r64]	n/a	10	10	/icd10m/version39.0-fullcode-cms/fullcode_cms/P0115.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0013.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0014.html	all 10 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	9	37	/priorities/innovation/innovation-models/vbid /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 9 pages (CSV)
Image has accessible name [sia-r2]	n/a	8	8	/icd10m/version39.0-fullcode-cms/fullcode_cms/P0115.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0013.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0014.html	all 8 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	3	6	/medicare-coverage-database/view/medcac-meeting.aspx /medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 3 pages (CSV)
Table cell has header [sia-r77]	n/a	2	69	/medicare-coverage-database/reports/national-coverage-medicare-coverage-documents-report.aspx /medicare-coverage-database/view/ncd.aspx	all 2 pages (CSV)
Duplicate role landmark is labeled [sia-r79]	n/a	2	2	/medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 2 pages (CSV)
aria-hidden element is not exposed to assistive technology [sia-r45]	n/a	1	21	/medicare/regulations-guidance/transmittals/2022-transmittals	all 1 pages (CSV)
Link has accessible name [sia-r11]	n/a	1	2	/medicare/quality/clinical-laboratory-improvement-amendments	all 1 pages (CSV)
No obsolete or deprecated elements are used [sia-r70]	n/a	1	1	/medicare-coverage-database/view/ncacal-decision-memo.aspx	all 1 pages (CSV)

Unique accessibility issues (axe + Alfa consolidated)

axe and Alfa both implement W3C ACT rules, so the same issue is often caught by both. These are deduplicated by ACT rule and page, so a shared finding counts once (10344 raw engine findings → 10306 unique).

Unique issues (rule × page): 10306
Caught by both engines: 38 highest confidence
axe only: 1881
Alfa only: 8387

5 rule type(s) caught by both engines — highest confidence

Two independent ACT-rule implementations (Deque axe-core and Siteimprove Alfa) flagged the same issue on the same pages. Agreement between separate engines is strong evidence the barrier is real, not a single-tool false positive — the best place to start.

Rules flagged by both axe-core and Alfa in 2026-W30, by pages affected.
Issue	Pages	Rule references
<html> element must have a lang attribute	58	axe html-has-lang · Alfa sia-r4 · ACT b5c3f8
Headings should not be empty	41	axe empty-heading · Alfa sia-r64 · ACT ffd0e9
Images must have alternative text	33	axe image-alt · Alfa sia-r2 · ACT 23a2a8
Table cell headers attributes must refer to other <th> elements in the same table	3	axe td-headers-attr · Alfa sia-r45 · ACT a25f45
Links must have discernible text	2	axe link-name · Alfa sia-r11 · ACT c487ae