www.cms.gov: Accessibility — week 2026-W31

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	1489	4	Component inconsistency
2.5.5	WCAG 2.5.5	1142	1
1.3.1	Info and Relationships (semantic structure)	472	7
1.4.1	Use of Color	449	2
2.5.3	WCAG 2.5.3	301	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 ~1128 finding(s) on 1128 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	1128	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 ~546 finding(s) on 546 page(s). XPath / selector: `text: "Feedback"`	Moderate	546	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 ~48 finding(s) on 48 page(s). XPath / selector: `html` `<html>`	Serious	48	Without vision, Limited cognitive, language, or learning ability	Add a lang attribute to <html> (e.g. lang="en").	pages (CSV)	Decision Assigned to Notes
Form elements must have labels · unattributed component Fix one place, resolve ~25 finding(s) on 25 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	25	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
Document should have one main landmark · unattributed component Fix one place, resolve ~48 finding(s) on 48 page(s). XPath / selector: `html` `<html>`	Moderate	48	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Images must have alternative text · unattributed component Fix one place, resolve ~23 finding(s) on 23 page(s). XPath / selector: `img[src$="cms-site-logo.png"]` `<img src="cms-site-logo.png">`	Critical	23	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
Page should contain a level-one heading · unattributed component Fix one place, resolve ~38 finding(s) on 38 page(s). XPath / selector: `html` `<html>`	Moderate	38	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
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~301 finding(s) on 301 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	301	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~270 finding(s) on 270 page(s). XPath / selector: `<a href="#" data-bs-toggle="collapse" id="aCollapseNavigation" aria-label="Collapse Document Navigation">`	Moderate	270	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Element has required aria-owns · unattributed component Fix one place, resolve ~49 finding(s) on 30 page(s). XPath / selector: `<th scope="col">`	Moderate	30	Without vision, Limited vision, Limited cognitive, language, or learning ability	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46	pages (CSV)	Decision Assigned to Notes

Bug reports

9 issue type(s) are shown by default out of 29 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 2 critical, 6 serious, 20 moderate, 1 minor. By WCAG category: 10 WCAG 2.0 A, 1 WCAG 2.0 AA, 1 WCAG 2.2 AA, 3 WCAG 2.x AAA, 8 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); 20 more are available if you switch to "Show everything".

1 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) 48/5543 pages · 48 instances Likely template

Bug ID: VS-13ed4817
Pattern ID: VS-c126b6a6
Combined ID: VS-13ed4817 (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/version39.0-fullcode-cms/fullcode_cms/P0260.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W31 (8 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 48 of 5543 scanned pages (48 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0260.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 48 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) 25/5543 pages · 25 instances Likely template

Bug ID: VS-46edb2df
Pattern ID: VS-fafffee0
Combined ID: VS-46edb2df (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/P1218.html
XPath / selector: #q
History: first seen 2026-W26, last seen 2026-W31 (6 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 25 of 5543 scanned pages (25 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1218.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

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) 23/5543 pages · 23 instances Likely template

Bug ID: VS-95ab2a02
Pattern ID: VS-9074b4dd
Combined ID: VS-95ab2a02 (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/version39.0-fullcode-cms/fullcode_cms/P0260.html
XPath / selector: img[src$="cms-site-logo.png"]
History: first seen 2026-W24, last seen 2026-W31 (7 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 23 of 5543 scanned pages (23 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0260.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) 7/5543 pages · 370 instances Likely template

Bug ID: VS-3f62cd22
Pattern ID: VS-a0bdbdf6
Combined ID: VS-3f62cd22 (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/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34046&lcdStatus=all&sortBy=title&ver=28
XPath / selector: #lblCmsNationalCoveragePolicy > ul:nth-child(2)
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

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

<ul>40.4 Speech-language pathology services</ul>

Description

<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 344 of 5543 scanned pages (1322 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34046&lcdStatus=all&sortBy=title&ver=28.
Locate the element: #lblCmsNationalCoveragePolicy > ul:nth-child(2)
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 link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 4/5543 pages · 9 instances

Bug ID: VS-de153830
Pattern ID: VS-e9fe47ac
Combined ID: VS-de153830 (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: http://cms.gov/priorities/burden-reduction/overview/customer-engagement/accountable-care-organization-aco-engagement
XPath / selector: .cms-text--prominent.field--name-body.field--type-text-with-summary > a[href="/media/563001"][data-once="linkMatch"]
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

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

<a href="/media/563001" data-once="linkMatch"></a>

Description

Links must have discernible text. Detected by axe-core rule link-name on 4 of 5543 scanned pages (9 instances).

Steps to reproduce

Open http://cms.gov/priorities/burden-reduction/overview/customer-engagement/accountable-care-organization-aco-engagement.
Locate the element: .cms-text--prominent.field--name-body.field--type-text-with-summary > a[href="/media/563001"][data-once="linkMatch"]
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 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) 3/5543 pages · 3 instances

Bug ID: VS-17954225
Pattern ID: VS-07ba3b17
Combined ID: VS-17954225 (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://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=16&sort=asc
XPath / selector: .MsoTableGrid
History: first seen 2026-W25, last seen 2026-W31 (7 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 5543 scanned pages (3 instances).

Steps to reproduce

Open https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=16&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 valid-lang WCAG 2.0 AA lang attribute must have a valid value (WCAG 3.1.2) 1/5543 pages · 6 instances

Bug ID: VS-99c703f4
Pattern ID: VS-dd1c019f
Combined ID: VS-99c703f4 (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: http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33609&lcdStatus=all&sortBy=title&ver=14
XPath / selector: li:nth-child(1) > span[lang="X-NONE"]
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

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

<span lang="X-NONE">

Description

lang attribute must have a valid value. Detected by axe-core rule valid-lang on 3 of 5543 scanned pages (19 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33609&lcdStatus=all&sortBy=title&ver=14.
Locate the element: li:nth-child(1) > 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) 1/5543 pages · 3 instances Likely content

Bug ID: VS-78d04bcc
Pattern ID: VS-bd13f00a
Combined ID: VS-78d04bcc (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/P0316.html
XPath / selector: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0315.html"]
History: first seen 2026-W25, last seen 2026-W31 (5 wk)

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

<a accesskey="p" id="prev_page" href="P0315.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 1 of 5543 scanned pages (3 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0316.html.
Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0315.html"]
Confirm the axe-core finding for rule accesskeys.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0316.html

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) 14/5543 pages · 14 instances Likely template

Bug ID: VS-5d271954
Pattern ID: VS-7a0e5645
Combined ID: VS-5d271954 (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://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html
XPath / selector: <html>
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

Description

Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 14 of 5543 scanned pages (14 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.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) 546/5543 pages · 546 instances Likely template

Bug ID: VS-e1a40034
Pattern ID: VS-c18be945
Combined ID: VS-e1a40034 (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://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A76&f%5B2%5D=topic%3A111&f%5B3%5D=topic%3A121&f%5B4%5D=topic%3A126&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A436&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-W31 (8 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 546 of 5543 scanned pages (546 instances).

Steps to reproduce

Open https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A76&f%5B2%5D=topic%3A111&f%5B3%5D=topic%3A121&f%5B4%5D=topic%3A126&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A436&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 546 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) 48/5543 pages · 1060 instances Likely template

Bug ID: VS-e017670d
Pattern ID: VS-f18df681
Combined ID: VS-e017670d (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/version39.0-fullcode-cms/fullcode_cms/P0260.html
XPath / selector: .arrows > tbody > tr:nth-child(1)
History: first seen 2026-W24, last seen 2026-W31 (8 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 v39.0 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 48 of 5543 scanned pages (1060 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0260.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 48 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) 48/5543 pages · 48 instances Likely template

Bug ID: VS-073a7e5e
Pattern ID: VS-d5d82446
Combined ID: VS-073a7e5e (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/version39.0-fullcode-cms/fullcode_cms/P0260.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W31 (8 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 48 of 5543 scanned pages (48 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0260.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 48 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) 38/5543 pages · 38 instances Likely template

Bug ID: VS-4f43c528
Pattern ID: VS-fa44f293
Combined ID: VS-4f43c528 (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/P1218.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W31 (8 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 38 of 5543 scanned pages (38 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1218.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 38 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) 22/5543 pages · 26 instances Likely template

Bug ID: VS-79c3d473
Pattern ID: VS-0066c67d
Combined ID: VS-79c3d473 (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: http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39591&lcdStatus=all&sortBy=title&ver=11
XPath / selector: #lblSummaryOfEvidence > h2
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

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

<h2 style="line-height: 115%;"><span style="line-height: 115%;"> </span></h2>

Description

Headings should not be empty. Detected by axe-core rule empty-heading on 29 of 5543 scanned pages (29 instances).

Steps to reproduce

Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39591&lcdStatus=all&sortBy=title&ver=11.
Locate the element: #lblSummaryOfEvidence > h2
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 alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 16/5543 pages · 28051 instances Likely template

Bug ID: VS-a10bcb7d
Pattern ID: VS-cb53cc4d
Combined ID: VS-a10bcb7d (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/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A76&f%5B2%5D=topic%3A111&f%5B3%5D=topic%3A121&f%5B4%5D=topic%3A126&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A436&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
XPath / selector: <a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 1142 of 5543 scanned pages (43830 instances).

Steps to reproduce

Open https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A76&f%5B2%5D=topic%3A111&f%5B3%5D=topic%3A121&f%5B4%5D=topic%3A126&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A436&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC.
Locate the element: <a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">
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) 16/5543 pages · 7952 instances Likely template

Bug ID: VS-a79ec2e3
Pattern ID: VS-2208081b
Combined ID: VS-a79ec2e3 (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/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A76&f%5B2%5D=topic%3A111&f%5B3%5D=topic%3A121&f%5B4%5D=topic%3A126&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A436&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
XPath / selector: <p class="ds-c-usa-banner__header-text">
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 1140 of 5543 scanned pages (12425 instances).

Steps to reproduce

Open https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A76&f%5B2%5D=topic%3A111&f%5B3%5D=topic%3A121&f%5B4%5D=topic%3A126&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A436&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC.
Locate the element: <p class="ds-c-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) 16/5543 pages · 722 instances Likely template

Bug ID: VS-2070b99d
Pattern ID: VS-7118fead
Combined ID: VS-2070b99d (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/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A76&f%5B2%5D=topic%3A111&f%5B3%5D=topic%3A121&f%5B4%5D=topic%3A126&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A436&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 1128 of 5543 scanned pages (1128 instances).

Steps to reproduce

Open https://www.cms.gov/newsroom/search?f%5B0%5D=newsroom_article_type%3A29586&f%5B1%5D=topic%3A76&f%5B2%5D=topic%3A111&f%5B3%5D=topic%3A121&f%5B4%5D=topic%3A126&f%5B5%5D=topic%3A176&f%5B6%5D=topic%3A231&f%5B7%5D=topic%3A436&items_per_page=10&search_api_language=en&sort_by=field_date&sort_order=DESC.
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-r64 WCAG 2.0 A Element has required owned roles (WCAG 1.3.1) 8/5543 pages · 8 instances

Bug ID: VS-ad201230
Pattern ID: VS-3c632d31
Combined ID: VS-ad201230 (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/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 8 of 5543 scanned pages (8 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.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 alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 8/5543 pages · 8 instances

Bug ID: VS-1555c439
Pattern ID: VS-a24eaa8c
Combined ID: VS-1555c439 (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/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html
XPath / selector: <img src="cms-site-logo.png">
History: first seen 2026-W24, last seen 2026-W31 (7 wk)

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 8 of 5543 scanned pages (8 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.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 deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 6/5543 pages · 112 instances Likely template

Bug ID: VS-962dfd0a
Pattern ID: VS-04a9d28c
Combined ID: VS-962dfd0a (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: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1218.html
XPath / selector: table
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

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

<table class="hhshead" cellpadding="0" cellspacing="0" summary="HHS Header. Table for formatting only.">
	<tbody><tr><td class="hhsbann" align="left">
    <img class="hhsimg" src="hhs_left.gif" width=

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 24 of 5543 scanned pages (446 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1218.html.
Locate the element: table
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-r75 Undetermined Form field error is identified and described (WCAG criterion undetermined) 6/5543 pages · 12 instances

Bug ID: VS-ffc238f8
Pattern ID: VS-e43903a1
Combined ID: VS-ffc238f8 (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/P1218.html
XPath / selector: <ul id="globar">
History: first seen 2026-W26, last seen 2026-W31 (6 wk)

Description

Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 6 of 5543 scanned pages (12 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1218.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) 6/5543 pages · 6 instances

Bug ID: VS-91ed08db
Pattern ID: VS-7fbb8b20
Combined ID: VS-91ed08db (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/P1218.html
XPath / selector: {"type":"document","children":[{"type":"element","children":[{"type":"element","
History: first seen 2026-W26, last seen 2026-W31 (6 wk)

Description

Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 6 of 5543 scanned pages (6 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1218.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 axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 5/5543 pages · 43 instances Likely template

Bug ID: VS-c3f22959
Pattern ID: VS-d25f622d
Combined ID: VS-c3f22959 (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: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=36551&lcdStatus=all&sortBy=title&stateRegion=all
XPath / selector: #navStickyHeader
History: first seen 2026-W24, last seen 2026-W31 (8 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 209 of 5543 scanned pages (213 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=36551&lcdStatus=all&sortBy=title&stateRegion=all.
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-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 4/5543 pages · 32 instances Likely template

Bug ID: VS-071d9688
Pattern ID: VS-179ad9b3
Combined ID: VS-071d9688 (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: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38816&ver=6
XPath / selector: <a href="#lblIssueDescriptionSubheader" data-href="lblIssueDescriptionSubheader" class="nav-link toc-link no-link log-click" title="Jump to Issue Description">
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 94 of 5543 scanned pages (200 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38816&ver=6.
Locate the element: <a href="#lblIssueDescriptionSubheader" data-href="lblIssueDescriptionSubheader" class="nav-link toc-link no-link log-click" title="Jump to Issue Description">
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 axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 4/5543 pages · 4 instances

Bug ID: VS-af260a87
Pattern ID: VS-8806389c
Combined ID: VS-af260a87 (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: http://www.cms.gov/priorities/health-equity/minority-health/resource-center/webinars-trainings/coverage-care-c2c-webinars
XPath / selector: .ds-u-lg-padding--0.ds-u-margin-y--2.ds-u-lg-margin-y--4:nth-child(8) > .ds-u-lg-padding-right--2.ds-l-lg-col--4.ds-u-padding-x--0 > div[role="region"]
History: first seen 2026-W25, last seen 2026-W31 (7 wk)

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

<div role="region">

Description

Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 4 of 5543 scanned pages (4 instances).

Steps to reproduce

Open http://www.cms.gov/priorities/health-equity/minority-health/resource-center/webinars-trainings/coverage-care-c2c-webinars.
Locate the element: .ds-u-lg-padding--0.ds-u-margin-y--2.ds-u-lg-margin-y--4:nth-child(8) > .ds-u-lg-padding-right--2.ds-l-lg-col--4.ds-u-padding-x--0 > div[role="region"]
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-r11 WCAG 2.0 A Link has accessible name (WCAG 2.4.4) 2/5543 pages · 3 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-W31 (8 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-de153830 (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 2 of 5543 scanned pages (3 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

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

Moderate alfa sia-r80 WCAG 2.x AAA Scrollable element is keyboard accessible (WCAG 1.4.8) 1/5543 pages · 13 instances Likely template

Bug ID: VS-f783446e
Pattern ID: VS-388b5438
Combined ID: VS-f783446e (pattern VS-388b5438) — 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 — Scrollable element is keyboard accessible [sia-r80]
Example URL: http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56152&articleStatus=all&bc=3&sortBy=title&ver=35
XPath / selector: <p style="line-height: 16.05pt;">
History: first seen 2026-W25, last seen 2026-W31 (7 wk)

Description

Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 32 of 5543 scanned pages (330 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56152&articleStatus=all&bc=3&sortBy=title&ver=35.
Locate the element: <p style="line-height: 16.05pt;">
Confirm the Siteimprove Alfa finding for rule sia-r80 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/sf5510-authorization-agreement-preauthorized-payments

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-r80

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 1/5543 pages · 7 instances Likely template

Bug ID: VS-d5c5c8bf
Pattern ID: VS-2cd767ca
Combined ID: VS-d5c5c8bf (pattern VS-2cd767ca) — 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 — Table header has scope [sia-r78]
Example URL: http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56152&articleStatus=all&bc=3&sortBy=title&ver=35
XPath / selector: <h4>
History: first seen 2026-W24, last seen 2026-W31 (8 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 121 of 5543 scanned pages (170 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56152&articleStatus=all&bc=3&sortBy=title&ver=35.
Locate the element: <h4>
Confirm the Siteimprove Alfa finding for rule sia-r78.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.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-r78

Triage status Notes

Moderate axe landmark-banner-is-top-level Best Practice Banner landmark should not be contained in another landmark (WCAG criterion undetermined) 1/5543 pages · 1 instances Likely content

Bug ID: VS-9a391305
Pattern ID: VS-30db094d
Combined ID: VS-9a391305 (pattern VS-30db094d) — 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 — Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]
Example URL: https://cms.gov/data-research/statistics-trends-and-reports/cms-fast-facts
XPath / selector: .Header
History: first seen 2026-W24, last seen 2026-W31 (6 wk)

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

<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 5543 scanned pages (1 instances).

Steps to reproduce

Open https://cms.gov/data-research/statistics-trends-and-reports/cms-fast-facts.
Locate the element: .Header
Confirm the axe-core finding for rule landmark-banner-is-top-level.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/data-research/statistics-trends-and-reports/cms-fast-facts

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

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (22 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-W31, 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	445	1088	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 445 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	344	1322	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 344 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	209	213	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /priorities/health-equity/minority-health/resource-center/webinars-trainings/coverage-care-c2c-webinars	all 209 pages (CSV)
All page content should be contained by landmarks [region]	moderate	48	1060	/icd10m/version39.0-fullcode-cms/fullcode_cms/P0260.html /icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0316.html	all 48 pages (CSV)
<html> element must have a lang attribute [html-has-lang]	serious	48	48	/icd10m/version39.0-fullcode-cms/fullcode_cms/P0260.html /icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0316.html	all 48 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	48	48	/icd10m/version39.0-fullcode-cms/fullcode_cms/P0260.html /icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0316.html	all 48 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	38	38	/icd10m/version33-fullcode-cms/fullcode_cms/P1218.html /icd10m/version33-fullcode-cms/fullcode_cms/P1353.html /priorities/key-initiatives/hospital-price-transparency/enforcement-actions	all 38 pages (CSV)
Headings should not be empty [empty-heading]	minor	29	29	/medicare-coverage-database/view/lcd.aspx /icd10m/version39.0-fullcode-cms/fullcode_cms/P0260.html /icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html	all 29 pages (CSV)
Form elements must have labels [label]	critical	25	25	/icd10m/version33-fullcode-cms/fullcode_cms/P1218.html /icd10m/version33-fullcode-cms/fullcode_cms/P1353.html /icd10m/version33-fullcode-cms/fullcode_cms/P0726.html	all 25 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	24	429	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/ncd.aspx	all 24 pages (CSV)
Images must have alternative text [image-alt]	critical	23	23	/icd10m/version39.0-fullcode-cms/fullcode_cms/P0260.html /icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0316.html	all 23 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	14	736	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 14 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	8	31	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx	all 8 pages (CSV)
<li> elements must be contained in a <ul> or <ol> [listitem]	serious	7	69	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-tracking-sheet.aspx	all 7 pages (CSV)
Links must have discernible text [link-name]	serious	4	9	/priorities/burden-reduction/overview/customer-engagement/accountable-care-organization-aco-engagement /medicare/quality/clinical-laboratory-improvement-amendments /medicare/quality/clinical-laboratory-improvement-amendments	all 4 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	4	4	/priorities/health-equity/minority-health/resource-center/webinars-trainings/coverage-care-c2c-webinars /apps/media/press_releases.asp /apps/media/press_releases.asp	all 4 pages (CSV)
lang attribute must have a valid value [valid-lang]	serious	3	19	/medicare-coverage-database/view/lcd.aspx /data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings /medicare-coverage-database/view/lcd.aspx	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/2020-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals	all 3 pages (CSV)
accesskey attribute value should be unique [accesskeys]	serious	1	3	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0316.html	all 1 pages (CSV)
Alternative text of images should not be repeated as text [image-redundant-alt]	minor	1	2	/medicare-coverage-database/view/ncacal-decision-memo.aspx	all 1 pages (CSV)
Scrollable region must have keyboard access [scrollable-region-focusable]	serious	1	1	/medicare-coverage-database/view/ncacal-decision-memo.aspx	all 1 pages (CSV)
Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]	moderate	1	1	/data-research/statistics-trends-and-reports/cms-fast-facts	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-W31, 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	1142	43830	/newsroom/search /newsroom/search /newsroom/search	all 1142 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	1140	12425	/newsroom/search /newsroom/search /newsroom/search	all 1140 pages (CSV)
Form field label is visible [sia-r61]	n/a	1128	1128	/newsroom/search /newsroom/search /newsroom/search	all 1128 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	546	546	/newsroom/search /newsroom/search /newsroom/search	all 546 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	303	25038	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 303 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	301	1609	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 301 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	301	753	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 301 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	280	281	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 280 pages (CSV)
Table header has scope [sia-r78]	n/a	121	170	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 121 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	94	200	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 94 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	77	228	/medicare-coverage-database/view/nca.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx	all 77 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	32	330	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 32 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	30	49	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 30 pages (CSV)
iframe element is not empty [sia-r71]	n/a	14	154	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 14 pages (CSV)
Document has a valid lang attribute [sia-r4]	n/a	14	14	/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html /icd10m/version33-fullcode-cms/fullcode_cms/P1218.html /icd10m/version33-fullcode-cms/fullcode_cms/P1353.html	all 14 pages (CSV)
Image has accessible name [sia-r2]	n/a	8	8	/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html /icd10m/version38-fullcode-cms/fullcode_cms/P0087.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0321.html	all 8 pages (CSV)
Element has required owned roles [sia-r64]	n/a	8	8	/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0010.html /icd10m/version38-fullcode-cms/fullcode_cms/P0087.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0321.html	all 8 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	6	51	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 6 pages (CSV)
Form field error is identified and described [sia-r75]	n/a	6	12	/icd10m/version33-fullcode-cms/fullcode_cms/P1218.html /icd10m/version33-fullcode-cms/fullcode_cms/P1353.html /icd10m/version33-fullcode-cms/fullcode_cms/P0726.html	all 6 pages (CSV)
Element with orientation is not locked [sia-r59]	n/a	6	6	/icd10m/version33-fullcode-cms/fullcode_cms/P1218.html /icd10m/version33-fullcode-cms/fullcode_cms/P1353.html /icd10m/version33-fullcode-cms/fullcode_cms/P0726.html	all 6 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	4	4	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 4 pages (CSV)
Table cell has header [sia-r77]	n/a	3	60	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/medcac-meeting.aspx	all 3 pages (CSV)
No obsolete or deprecated elements are used [sia-r70]	n/a	3	3	/medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncd.aspx	all 3 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	2	60	/medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/ncd.aspx	all 2 pages (CSV)
Link has accessible name [sia-r11]	n/a	2	3	/medicare/quality/clinical-laboratory-improvement-amendments /data-research/monitoring-programs/medicare-fee-service-compliance-programs/medical-review-education/hospice	all 2 pages (CSV)
Duplicate role landmark is labeled [sia-r79]	n/a	2	2	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 2 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 (6901 raw engine findings → 6869 unique).

Unique issues (rule × page): 6869
Caught by both engines: 32 highest confidence
axe only: 1296
Alfa only: 5541

4 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-W31, by pages affected.
Issue	Pages	Rule references
<html> element must have a lang attribute	48	axe html-has-lang · Alfa sia-r4 · ACT b5c3f8
Headings should not be empty	29	axe empty-heading · Alfa sia-r64 · ACT ffd0e9
Images must have alternative text	23	axe image-alt · Alfa sia-r2 · ACT 23a2a8
Links must have discernible text	4	axe link-name · Alfa sia-r11 · ACT c487ae