www.cms.gov: Accessibility — week 2026-W33

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	1352	4	Component inconsistency
2.5.5	WCAG 2.5.5	838	1
1.4.1	Use of Color	670	2
1.3.1	Info and Relationships (semantic structure)	573	9
1.4.6	WCAG 1.4.6	453	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 ~809 finding(s) on 809 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	809	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
<html> element must have a lang attribute · unattributed component Fix one place, resolve ~127 finding(s) on 127 page(s). XPath / selector: `html` `<html>`	Serious	127	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 ~127 finding(s) on 127 page(s). XPath / selector: `html` `<html>`	Moderate	127	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~248 finding(s) on 248 page(s). XPath / selector: `text: "Feedback"`	Moderate	248	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Images must have alternative text · unattributed component Fix one place, resolve ~98 finding(s) on 98 page(s). XPath / selector: `img[src$="cms-site-logo.png"]` `<img src="cms-site-logo.png">`	Critical	98	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
Form elements must have labels · unattributed component Fix one place, resolve ~29 finding(s) on 29 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	29	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
Page should contain a level-one heading · unattributed component Fix one place, resolve ~42 finding(s) on 42 page(s). XPath / selector: `html` `<html>`	Moderate	42	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 ~450 finding(s) on 450 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	450	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 ~407 finding(s) on 407 page(s). XPath / selector: `<a href="#" data-bs-toggle="collapse" id="aCollapseNavigation" aria-label="Collapse Document Navigation">`	Moderate	407	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Text has enhanced contrast · unattributed component Fix one place, resolve ~450 finding(s) on 450 page(s). XPath / selector: `text: "Here's how you know"`	Moderate	450	Requires manual testing.	Increase text contrast to meet WCAG AAA (7:1).	pages (CSV)	Decision Assigned to Notes

Bug reports

12 issue type(s) are shown by default out of 36 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 3 critical, 6 serious, 25 moderate, 2 minor. By WCAG category: 13 WCAG 2.0 A, 2 WCAG 2.0 AA, 1 WCAG 2.2 AA, 2 WCAG 2.x AAA, 10 Best Practice, 8 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 12 prioritized issue type(s); 24 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) 127/6702 pages · 127 instances Likely template

Bug ID: VS-17dca749
Pattern ID: VS-c126b6a6
Combined ID: VS-17dca749 (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://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W33 (10 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 127 of 6702 scanned pages (127 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.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 127 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 image-alt WCAG 2.0 A Images must have alternative text (WCAG 1.1.1) 99/6702 pages · 99 instances Likely template

Bug ID: VS-633db298
Pattern ID: VS-9074b4dd
Combined ID: VS-633db298 (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/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
XPath / selector: img[src$="cms-site-logo.png"]
History: first seen 2026-W24, last seen 2026-W33 (9 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 99 of 6702 scanned pages (99 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.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

…and more — all 99 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: 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

Critical axe label WCAG 2.0 A Form elements must have labels (WCAG 4.1.2) 29/6702 pages · 29 instances Likely template

Bug ID: VS-6287d1e8
Pattern ID: VS-fafffee0
Combined ID: VS-6287d1e8 (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/P0918.html
XPath / selector: #q
History: first seen 2026-W26, last seen 2026-W33 (8 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 29 of 6702 scanned pages (29 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.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 29 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

Serious axe link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 3/6702 pages · 6 instances

Bug ID: VS-fa279db0
Pattern ID: VS-e9fe47ac
Combined ID: VS-fa279db0 (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://www.cms.gov/medicare/medicare-contracting/medicare-administrative-contractors/archive-j11-now-known-as-jurisdiction-m
XPath / selector: a[data-entity-type="node"][data-entity-substitution="canonical"][data-once="linkMatch"]:nth-child(1)
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

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

<a href="/medicare/medicare-contracting/medicare-administrative-contractors/who-are-the-macs-a-b-mac-jurisdiction-m-jm" data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="d

Description

Links must have discernible text. Detected by axe-core rule link-name on 3 of 6702 scanned pages (6 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/medicare-contracting/medicare-administrative-contractors/archive-j11-now-known-as-jurisdiction-m.
Locate the element: a[data-entity-type="node"][data-entity-substitution="canonical"][data-once="linkMatch"]:nth-child(1)
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) 2/6702 pages · 2 instances Likely content

Bug ID: VS-b5046566
Pattern ID: VS-07ba3b17
Combined ID: VS-b5046566 (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/2020-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=14&sort=asc
XPath / selector: .MsoTableGrid
History: first seen 2026-W25, last seen 2026-W33 (9 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 2 of 6702 scanned pages (2 instances).

Steps to reproduce

Open https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=14&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

Critical axe aria-allowed-attr WCAG 2.0 A Elements must only use supported ARIA attributes (WCAG 4.1.2) 1/6702 pages · 4 instances Likely content

Bug ID: VS-f6b01f33
Pattern ID: VS-1467ea8a
Combined ID: VS-f6b01f33 (pattern VS-1467ea8a) — 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 — Elements must only use supported ARIA attributes [aria-allowed-attr]
Example URL: http://cms.gov/files/linked-video-files/new-features-medicare-gov
XPath / selector: a[title="Home"]
History: first seen 2026-W25, last seen 2026-W33 (5 wk)

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

<a id="endpoint" class="yt-simple-endpoint style-scope ytd-mini-guide-entry-renderer" aria-selected="false" aria-label="Home" title="Home" href="/">

Description

Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 1 of 6702 scanned pages (4 instances).

Steps to reproduce

Open http://cms.gov/files/linked-video-files/new-features-medicare-gov.
Locate the element: a[title="Home"]
Confirm the axe-core finding for rule aria-allowed-attr 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

/files/linked-video-files/new-features-medicare-gov

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 ARIA attributes that aren't allowed on this role/element.

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

Triage status Notes

Serious axe nested-interactive WCAG 2.0 A Interactive controls must not be nested (WCAG 4.1.2) 1/6702 pages · 1 instances Likely content

Bug ID: VS-100743f3
Pattern ID: VS-58301a87
Combined ID: VS-100743f3 (pattern VS-58301a87) — 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 — Interactive controls must not be nested [nested-interactive]
Example URL: http://cms.gov/files/linked-video-files/new-features-medicare-gov
XPath / selector: .ytPageHeaderViewModelScrollContainer > .ytPageHeaderViewModelContent > .ytPageHeaderViewModelHeadline > .ytPageHeaderViewModelHeadlineInfo > .ytPageHeaderViewModelContentMetadata.ytPageHeaderViewModelContentMetadataOverlay > .ytContentMetadataViewModelMetadataRow[role="group"]:nth-child(1) > yt-avatar-stack-view-model
History: first seen 2026-W33, last seen 2026-W33 (1 wk)

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

<yt-avatar-stack-view-model class="ytAvatarStackViewModelHost ytContentMetadataViewModelAvatarStack ytAvatarStackViewModelTappable ytAvatarStackViewModelIsOverlay" tabindex="0" role="button" aria-labe

Description

Interactive controls must not be nested. Detected by axe-core rule nested-interactive on 1 of 6702 scanned pages (1 instances).

Steps to reproduce

Open http://cms.gov/files/linked-video-files/new-features-medicare-gov.
Locate the element: .ytPageHeaderViewModelScrollContainer > .ytPageHeaderViewModelContent > .ytPageHeaderViewModelHeadline > .ytPageHeaderViewModelHeadlineInfo > .ytPageHeaderViewModelContentMetadata.ytPageHeaderViewModelContentMetadataOverlay > .ytContentMetadataViewModelMetadataRow[role="group"]:nth-child(1) > yt-avatar-stack-view-model
Confirm the axe-core finding for rule nested-interactive 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

/files/linked-video-files/new-features-medicare-gov

Testing environment

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

Suggested fix

How to fix: Don't nest interactive controls (e.g. a button inside a link); split them apart.

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

Triage status Notes

Serious axe valid-lang WCAG 2.0 AA lang attribute must have a valid value (WCAG 3.1.2) 1/6702 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-W33 (10 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 6702 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) 39/6702 pages · 113 instances Likely template

Bug ID: VS-9e10d04e
Pattern ID: VS-bd13f00a
Combined ID: VS-9e10d04e (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/P0365.html
XPath / selector: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0364.html"]
History: first seen 2026-W25, last seen 2026-W33 (7 wk)

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

<a accesskey="p" id="prev_page" href="P0364.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 39 of 6702 scanned pages (113 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html.
Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0364.html"]
Confirm the axe-core finding for rule accesskeys.

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/accesskeys?application=axeAPI

Triage status Notes

Moderate alfa sia-r4 WCAG 2.0 A Document has a valid lang attribute (WCAG 3.1.1) 28/6702 pages · 28 instances Likely template

Bug ID: VS-73eea048
Pattern ID: VS-7a0e5645
Combined ID: VS-73eea048 (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/P0918.html
XPath / selector: <html>
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 28 of 6702 scanned pages (28 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.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

…and more — all 28 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 25/6702 pages · 25 instances Likely template

Bug ID: VS-27220a16
Pattern ID: VS-a24eaa8c
Combined ID: VS-27220a16 (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/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
XPath / selector: <img src="cms-site-logo.png">
History: first seen 2026-W24, last seen 2026-W33 (9 wk)

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 25 of 6702 scanned pages (25 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.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-r64 WCAG 2.0 A Element has required owned roles (WCAG 1.3.1) 19/6702 pages · 24 instances Likely template

Bug ID: VS-453b3336
Pattern ID: VS-3c632d31
Combined ID: VS-453b3336 (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/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 30 of 6702 scanned pages (32 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.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-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 248/6702 pages · 249 instances Likely template

Bug ID: VS-8cdd5dcf
Pattern ID: VS-c18be945
Combined ID: VS-8cdd5dcf (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/priorities/innovation-center/value-based-care-spotlight/patient-provider-voices/whole-person-care-stories/improving-health-access-care-rural-areas-one-pennsylvania-couples-story
XPath / selector: text: "Feedback"
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 248 of 6702 scanned pages (249 instances).

Steps to reproduce

Open https://www.cms.gov/priorities/innovation-center/value-based-care-spotlight/patient-provider-voices/whole-person-care-stories/improving-health-access-care-rural-areas-one-pennsylvania-couples-story.
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 248 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) 128/6702 pages · 2279 instances Likely template

Bug ID: VS-846ac887
Pattern ID: VS-f18df681
Combined ID: VS-846ac887 (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://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
XPath / selector: .hhshead[cellpadding="0"][cellspacing="0"]:nth-child(1)
History: first seen 2026-W24, last seen 2026-W33 (10 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.">

Description

All page content should be contained by landmarks. Detected by axe-core rule region on 128 of 6702 scanned pages (2279 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
Locate the element: .hhshead[cellpadding="0"][cellspacing="0"]: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 128 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) 127/6702 pages · 127 instances Likely template

Bug ID: VS-41df8942
Pattern ID: VS-d5d82446
Combined ID: VS-41df8942 (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://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W33 (10 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 127 of 6702 scanned pages (127 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.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 127 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) 42/6702 pages · 42 instances Likely template

Bug ID: VS-a90d129c
Pattern ID: VS-fa44f293
Combined ID: VS-a90d129c (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/P0918.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W33 (10 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 42 of 6702 scanned pages (42 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.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 42 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) 23/6702 pages · 104 instances Likely template

Bug ID: VS-e7dcc132
Pattern ID: VS-0066c67d
Combined ID: VS-e7dcc132 (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/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
XPath / selector: h1:nth-child(2)
History: first seen 2026-W24, last seen 2026-W33 (10 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 109 of 6702 scanned pages (113 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.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 alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 13/6702 pages · 13815 instances Likely template

Bug ID: VS-df141fc5
Pattern ID: VS-cb53cc4d
Combined ID: VS-df141fc5 (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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
XPath / selector: <a href="#h3LcdGuidanceHeader" data-href="h3LcdGuidanceHeader" class="nav-link toc-link no-link log-click" title="Jump to Coverage Guidance">
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 838 of 6702 scanned pages (26567 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19.
Locate the element: <a href="#h3LcdGuidanceHeader" data-href="h3LcdGuidanceHeader" class="nav-link toc-link no-link log-click" title="Jump to Coverage Guidance">
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) 12/6702 pages · 5444 instances Likely template

Bug ID: VS-f53ec98f
Pattern ID: VS-2208081b
Combined ID: VS-f53ec98f (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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
XPath / selector: <p class="usa-banner__header-text">
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 829 of 6702 scanned pages (11341 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19.
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) 11/6702 pages · 356 instances Likely template

Bug ID: VS-a033b296
Pattern ID: VS-7118fead
Combined ID: VS-a033b296 (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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 809 of 6702 scanned pages (809 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19.
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 deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 6/6702 pages · 106 instances Likely template

Bug ID: VS-a1d378eb
Pattern ID: VS-04a9d28c
Combined ID: VS-a1d378eb (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://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html
XPath / selector: img
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

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

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

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 25 of 6702 scanned pages (441 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html.
Locate the element: img
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-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 6/6702 pages · 72 instances Likely template

Bug ID: VS-0df4355f
Pattern ID: VS-179ad9b3
Combined ID: VS-0df4355f (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/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
XPath / selector: <a href="http://www.cms.gov/" title="CMS Home Page">
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 140 of 6702 scanned pages (300 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
Locate the element: <a href="http://www.cms.gov/" title="CMS Home Page">
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 heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 5/6702 pages · 59 instances Likely template

Bug ID: VS-0813c0bb
Pattern ID: VS-d25f622d
Combined ID: VS-0813c0bb (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-alphabetical-report.aspx?lcdid=39905&lcdStatus=all&sortBy=title
XPath / selector: #navStickyHeader
History: first seen 2026-W24, last seen 2026-W33 (10 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 290 of 6702 scanned pages (294 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=39905&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-r78 Undetermined Table header has scope (WCAG criterion undetermined) 5/6702 pages · 49 instances Likely template

Bug ID: VS-73f4fb49
Pattern ID: VS-2cd767ca
Combined ID: VS-73f4fb49 (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: https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 173 of 6702 scanned pages (245 instances).

Steps to reproduce

Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html.
Locate the element: <h1>
Confirm the Siteimprove Alfa finding for rule sia-r78.

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-r78

Triage status Notes

Moderate alfa sia-r75 Undetermined Form field error is identified and described (WCAG criterion undetermined) 4/6702 pages · 8 instances

Bug ID: VS-6bc59a90
Pattern ID: VS-e43903a1
Combined ID: VS-6bc59a90 (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/P0918.html
XPath / selector: <ul id="globar">
History: first seen 2026-W26, last seen 2026-W33 (8 wk)

Description

Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 4 of 6702 scanned pages (8 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.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) 4/6702 pages · 4 instances

Bug ID: VS-7b742ef1
Pattern ID: VS-7fbb8b20
Combined ID: VS-7b742ef1 (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/P0918.html
XPath / selector: {"type":"document","children":[{"type":"element","children":[{"type":"element","
History: first seen 2026-W26, last seen 2026-W33 (8 wk)

Description

Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 4 of 6702 scanned pages (4 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.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

Minor axe empty-table-header Best Practice Table header text should not be empty (WCAG criterion undetermined) 4/6702 pages · 5 instances Likely template

Bug ID: VS-3a6ca9c2
Pattern ID: VS-d69fc059
Combined ID: VS-3a6ca9c2 (pattern VS-d69fc059) — 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 — Table header text should not be empty [empty-table-header]
Example URL: https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36889&lcdStatus=all&sortBy=title&ver=24
XPath / selector: tbody > tr > th
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

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

<th>&nbsp;</th>

Description

Table header text should not be empty. Detected by axe-core rule empty-table-header on 16 of 6702 scanned pages (21 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36889&lcdStatus=all&sortBy=title&ver=24.
Locate the element: tbody > tr > th
Confirm the axe-core finding for rule empty-table-header.

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/empty-table-header?application=axeAPI

Triage status Notes

Moderate axe scope-attr-valid Best Practice scope attribute should be used correctly (WCAG criterion undetermined) 2/6702 pages · 39 instances Likely template

Bug ID: VS-fba107ff
Pattern ID: VS-0ba8ce9d
Combined ID: VS-fba107ff (pattern VS-0ba8ce9d) — 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 — scope attribute should be used correctly [scope-attr-valid]
Example URL: https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?fromdb=true&NCAId=246
XPath / selector: table[cellpadding="5"] > tbody > tr[valign="top"]:nth-child(2) > td[scope="row"]
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

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

<td scope="row">June 28, 2010</td>

Description

scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 22 of 6702 scanned pages (428 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?fromdb=true&NCAId=246.
Locate the element: table[cellpadding="5"] > tbody > tr[valign="top"]:nth-child(2) > td[scope="row"]
Confirm the axe-core finding for rule scope-attr-valid.

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/scope-attr-valid?application=axeAPI

Triage status Notes

Moderate alfa sia-r69 WCAG 2.0 AA Text has sufficient color contrast (Enhanced) (WCAG 1.4.3) 2/6702 pages · 11 instances

Bug ID: VS-b192767c
Pattern ID: VS-f7e99f4b
Combined ID: VS-b192767c (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://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52487&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=27
XPath / selector: text: "Column I"
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 9 of 6702 scanned pages (50 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52487&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=27.
Locate the element: text: "Column I"
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-banner-is-top-level Best Practice Banner landmark should not be contained in another landmark (WCAG criterion undetermined) 2/6702 pages · 2 instances Likely content

Bug ID: VS-e029d9da
Pattern ID: VS-30db094d
Combined ID: VS-e029d9da (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/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation
XPath / selector: .Header
History: first seen 2026-W24, last seen 2026-W33 (7 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 2 of 6702 scanned pages (2 instances).

Steps to reproduce

Open https://cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation.
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

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

Moderate alfa sia-r87 Undetermined First focusable element is link to main content (WCAG criterion undetermined) 2/6702 pages · 2 instances Likely content

Bug ID: VS-6629c655
Pattern ID: VS-aa242c2d
Combined ID: VS-6629c655 (pattern VS-aa242c2d) — 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 — First focusable element is link to main content [sia-r87]
Example URL: https://www.cms.gov/priorities/electronic-prior-authorization/overview
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W25, last seen 2026-W33 (6 wk)

Description

First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 2 of 6702 scanned pages (2 instances).

Steps to reproduce

Open https://www.cms.gov/priorities/electronic-prior-authorization/overview.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r87.

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-r87

Triage status Notes

Moderate alfa sia-r68 WCAG 2.0 A Presentational children of an element are not focusable (WCAG 1.3.1) 1/6702 pages · 17 instances Likely template

Bug ID: VS-febe0850
Pattern ID: VS-d6097011
Combined ID: VS-febe0850 (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/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
XPath / selector: <ul>
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 113 of 6702 scanned pages (424 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28.
Locate the element: <ul>
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/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.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-r45 WCAG 2.0 A aria-hidden element is not exposed to assistive technology (WCAG 1.3.1) 1/6702 pages · 13 instances · possible duplicate Likely content

Bug ID: VS-37b62026
Pattern ID: VS-9207ed51
Combined ID: VS-37b62026 (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://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=14&sort=asc
XPath / selector: @headers="view-field-dyna-release-date-table-column"
History: first seen 2026-W26, last seen 2026-W33 (6 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-b5046566 (pattern VS-07ba3b17). 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 6702 scanned pages (13 instances).

Steps to reproduce

Open https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=14&sort=asc.
Locate the element: @headers="view-field-dyna-release-date-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/2020-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-r42 WCAG 2.0 A Element in required WAI-ARIA context role (WCAG 1.3.1) 1/6702 pages · 5 instances · possible duplicate Likely content

Bug ID: VS-0be23131
Pattern ID: VS-0ddc2ac6
Combined ID: VS-0be23131 (pattern VS-0ddc2ac6) — 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 in required WAI-ARIA context role [sia-r42]
Example URL: https://www.cms.gov/
XPath / selector: <button type="button" id="trigger-tabs-1343730814" aria-expanded="false" class="responsive-tabs__tab-button--mobile ds-u-display--flex">
History: first seen 2026-W24, last seen 2026-W33 (5 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-b5046566 (pattern VS-07ba3b17). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Element in required WAI-ARIA context role. Detected by Siteimprove Alfa rule sia-r42 on 1 of 6702 scanned pages (5 instances).

Steps to reproduce

Open https://www.cms.gov/.
Locate the element: <button type="button" id="trigger-tabs-1343730814" aria-expanded="false" class="responsive-tabs__tab-button--mobile ds-u-display--flex">
Confirm the Siteimprove Alfa finding for rule sia-r42 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r18 Undetermined aria attribute is permitted for element role (WCAG criterion undetermined) 1/6702 pages · 3 instances Likely content

Bug ID: VS-c0deeae5
Pattern ID: VS-e05344b9
Combined ID: VS-c0deeae5 (pattern VS-e05344b9) — 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 — aria attribute is permitted for element role [sia-r18]
Example URL: https://cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation
XPath / selector: @aria-label="Open Medicare Advantage Geographic Variation - National & State"
History: first seen 2026-W25, last seen 2026-W33 (6 wk)

Description

aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 1 of 6702 scanned pages (3 instances).

Steps to reproduce

Open https://cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation.
Locate the element: @aria-label="Open Medicare Advantage Geographic Variation - National & State"
Confirm the Siteimprove Alfa finding for rule sia-r18.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation

Testing environment

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

Suggested fix

How to fix: Only use ARIA states/properties that are allowed on this element/role.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r18

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) 1/6702 pages · 1 instances Likely content

Bug ID: VS-1275e590
Pattern ID: VS-8806389c
Combined ID: VS-1275e590 (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://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-W33 (9 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 1 of 6702 scanned pages (1 instances).

Steps to reproduce

Open https://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

/priorities/health-equity/minority-health/resource-center/webinars-trainings/coverage-care-c2c-webinars

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

Deque axe-core findings

Rule-level axe-core summary (23 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-W33, 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	669	1526	/medicare-coverage-database/details/ncd-details.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 669 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	378	1760	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 378 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	290	294	/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx /medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/application-types-timeline /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 290 pages (CSV)
All page content should be contained by landmarks [region]	moderate	128	2279	/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /icd10m/version38-fullcode-cms/fullcode_cms/P0056.html	all 128 pages (CSV)
<html> element must have a lang attribute [html-has-lang]	serious	127	127	/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /icd10m/version38-fullcode-cms/fullcode_cms/P0056.html	all 127 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	127	127	/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /icd10m/version38-fullcode-cms/fullcode_cms/P0056.html	all 127 pages (CSV)
Headings should not be empty [empty-heading]	minor	109	113	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /icd10m/version38-fullcode-cms/fullcode_cms/P0056.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0005.html	all 109 pages (CSV)
Images must have alternative text [image-alt]	critical	99	99	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /icd10m/version38-fullcode-cms/fullcode_cms/P0056.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0005.html	all 99 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	42	42	/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html /icd10m/version33-fullcode-cms/fullcode_cms/P1137.html /icd10m/version33-fullcode-cms/fullcode_cms/P0017.html	all 42 pages (CSV)
accesskey attribute value should be unique [accesskeys]	serious	39	113	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0026.html	all 39 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	36	574	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 36 pages (CSV)
Form elements must have labels [label]	critical	29	29	/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html /icd10m/version33-fullcode-cms/fullcode_cms/P1137.html /icd10m/version33-fullcode-cms/fullcode_cms/P0017.html	all 29 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	22	428	/medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/medcac-meeting.aspx /medicare-coverage-database/view/ncd.aspx	all 22 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	16	21	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/medcac-meeting.aspx	all 16 pages (CSV)
<li> elements must be contained in a <ul> or <ol> [listitem]	serious	5	15	/medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/details/nca-view-public-comments.aspx	all 5 pages (CSV)
Links must have discernible text [link-name]	serious	3	6	/medicare/medicare-contracting/medicare-administrative-contractors/archive-j11-now-known-as-jurisdiction-m /cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs10 /medicare/quality/clinical-laboratory-improvement-amendments	all 3 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)
Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]	moderate	2	2	/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation /Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html	all 2 pages (CSV)
Table cell headers attributes must refer to other <th> elements in the same table [td-headers-attr]	serious	2	2	/medicare/regulations-guidance/transmittals/2020-transmittals /medicare/regulations-guidance/transmittals/2022-transmittals	all 2 pages (CSV)
Elements must only use supported ARIA attributes [aria-allowed-attr]	critical	1	4	/files/linked-video-files/new-features-medicare-gov	all 1 pages (CSV)
Interactive controls must not be nested [nested-interactive]	serious	1	1	/files/linked-video-files/new-features-medicare-gov	all 1 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)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	1	1	/priorities/health-equity/minority-health/resource-center/webinars-trainings/coverage-care-c2c-webinars	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (29 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-W33, 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	838	26567	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /priorities/innovation-center/value-based-care-spotlight/patient-provider-voices/whole-person-care-stories/improving-health-access-care-rural-areas-one-pennsylvania-couples-story	all 838 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	829	11341	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /priorities/innovation-center/value-based-care-spotlight/patient-provider-voices/whole-person-care-stories/improving-health-access-care-rural-areas-one-pennsylvania-couples-story	all 829 pages (CSV)
Form field label is visible [sia-r61]	n/a	809	809	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /priorities/innovation-center/value-based-care-spotlight/patient-provider-voices/whole-person-care-stories/improving-health-access-care-rural-areas-one-pennsylvania-couples-story	all 809 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	453	2917	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 453 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	452	32275	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 452 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	451	1084	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx	all 451 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	422	423	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 422 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	248	249	/priorities/innovation-center/value-based-care-spotlight/patient-provider-voices/whole-person-care-stories/improving-health-access-care-rural-areas-one-pennsylvania-couples-story /contacts/west-virginia-insurance-commission/general-beneficiary-contact/1562561 /ltch-webpricer	all 248 pages (CSV)
Table header has scope [sia-r78]	n/a	173	245	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 173 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	140	300	/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /medicare-coverage-database/view/ncd.aspx	all 140 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	113	424	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/nca.aspx /medicare-coverage-database/view/lcd.aspx	all 113 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	42	786	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 42 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	41	69	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 41 pages (CSV)
Element has required owned roles [sia-r64]	n/a	30	32	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /medicare-coverage-database/view/article.aspx /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html	all 30 pages (CSV)
iframe element is not empty [sia-r71]	n/a	29	673	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 29 pages (CSV)
Document has a valid lang attribute [sia-r4]	n/a	28	28	/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /icd10m/version33-fullcode-cms/fullcode_cms/P0017.html	all 28 pages (CSV)
Image has accessible name [sia-r2]	n/a	25	25	/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html /priorities/electronic-prior-authorization/overview /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html	all 25 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	9	50	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation	all 9 pages (CSV)
Duplicate role landmark is labeled [sia-r79]	n/a	5	5	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/details/nca-decision-memo.aspx	all 5 pages (CSV)
Form field error is identified and described [sia-r75]	n/a	4	8	/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html /icd10m/version33-fullcode-cms/fullcode_cms/P0017.html /icd10m/version33-fullcode-cms/fullcode_cms/P0248.html	all 4 pages (CSV)
Element with orientation is not locked [sia-r59]	n/a	4	4	/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html /icd10m/version33-fullcode-cms/fullcode_cms/P0017.html /icd10m/version33-fullcode-cms/fullcode_cms/P0248.html	all 4 pages (CSV)
No obsolete or deprecated elements are used [sia-r70]	n/a	3	3	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 3 pages (CSV)
Table cell has header [sia-r77]	n/a	2	9	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/medcac-meeting.aspx	all 2 pages (CSV)
First focusable element is link to main content [sia-r87]	n/a	2	2	/priorities/electronic-prior-authorization/overview /research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation	all 2 pages (CSV)
aria-hidden element is not exposed to assistive technology [sia-r45]	n/a	1	13	/medicare/regulations-guidance/transmittals/2020-transmittals	all 1 pages (CSV)
Element in required WAI-ARIA context role [sia-r42]	n/a	1	5	/	all 1 pages (CSV)
aria attribute is permitted for element role [sia-r18]	n/a	1	3	/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation	all 1 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	1	3	/medicare-coverage-database/details/nca-decision-memo.aspx	all 1 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	1	1	/medicare-coverage-database/view/lcd.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 (7286 raw engine findings → 7202 unique).

Unique issues (rule × page): 7202
Caught by both engines: 84 highest confidence
axe only: 2045
Alfa only: 5073

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-W33, by pages affected.
Issue	Pages	Rule references
<html> element must have a lang attribute	127	axe html-has-lang · Alfa sia-r4 · ACT b5c3f8
Headings should not be empty	109	axe empty-heading · Alfa sia-r64 · ACT ffd0e9
Images must have alternative text	99	axe image-alt · Alfa sia-r2 · ACT 23a2a8
Elements must only use supported ARIA attributes	2	axe aria-allowed-attr · Alfa sia-r18 · ACT 5c01ea
Table cell headers attributes must refer to other <th> elements in the same table	2	axe td-headers-attr · Alfa sia-r45 · ACT a25f45