# Accessibility bug reports — www.cms.gov, week 2026-W33

55 issue type(s) from 6702 pages scanned. Generated 2026-08-16 by [vital-scans](https://github.com/mgifford/vital-core), following [accessibility bug-reporting best practices](https://mgifford.github.io/ACCESSIBILITY.md/examples/ACCESSIBILITY_BUG_REPORTING_BEST_PRACTICES.html).

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

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

**Bug ID:** `VS-0df4355f`  
**Pattern ID:** `VS-179ad9b3`  
**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">`  
**WCAG SC:** 2.5.8 — Target Size (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r113` ([reference](https://alfa.siteimprove.com/rules/sia-r113))  
**Severity:** Moderate  
**Frequency:** 300 instances; 140 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### 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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
2. Locate the element: <a href="http://www.cms.gov/" title="CMS Home Page">
3. Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=292&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52490&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=25
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57482&articleStatus=all&bc=3&sortBy=title&ver=23
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56802&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=15
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57207&articleStatus=all&bc=3&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57037&articleStatus=all&bc=3&sortBy=title&ver=20
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54418&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=25
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53017&articleStatus=all&bc=3&sortBy=title&ver=34
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58503&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=12
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58116&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=28
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56793&articleStatus=all&bc=3&sortBy=title&ver=35
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57972&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=10
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59632&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=22
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56503&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=12
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57972&articleStatus=all&bc=3&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59620&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=5
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58344&ver=3

…and more — 140 pages total ([download CSV](csv/alfa__sia-r113.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-r113

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=292&ncdver=1&sortBy=title

---

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

**Bug ID:** `VS-6a00fdbe`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19  
**XPath / selector:** `<a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">`  
**WCAG SC:** 2.5.3 — Label in Name (Level A)  
**Rule:** Siteimprove Alfa — `sia-r14` ([reference](https://alfa.siteimprove.com/rules/sia-r14))  
**Severity:** Moderate  
**Frequency:** 1084 instances; 451 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 451 of 6702 scanned pages (1084 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19.
2. Locate the element: <a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40333&proposedStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36859&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35050&lcdStatus=all&sortBy=title&stateRegion=all&ver=55
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=334&ncdver=1&sortBy=title
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=292&ncdver=1&sortBy=title
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54899&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38904&lcdStatus=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52490&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=25
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55757&ver=5
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39270&lcdStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56865&ver=28
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37598&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40198&proposedStatus=all&sortBy=title&stateRegion=all&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=32
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=60348&articleStatus=all&bc=3&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57482&articleStatus=all&bc=3&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33575&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56802&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=15

…and more — 451 pages total ([download CSV](csv/alfa__sia-r14.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-r14

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-633db298`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html  
**XPath / selector:** `img[src$="cms-site-logo.png"]`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** axe-core — `image-alt` ([reference](https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 99 instances; 99 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (9 weeks)

### HTML snippet
```html
<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
1. Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html.
2. Locate the element: img[src$="cms-site-logo.png"]
3. Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

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

### Affected pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0056.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html
- https://www.cms.gov/priorities/electronic-prior-authorization/overview
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1905.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0165.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0296.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0053.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0026.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0126.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0338.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0020.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0017.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0280.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0011.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0035.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0381.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0064.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0011.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0009.html
- http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0014.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0125.html

…and more — 99 pages total ([download CSV](csv/axe-core__image-alt.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.

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

### Example pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0056.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0005.html

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-27220a16`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html  
**XPath / selector:** `<img src="cms-site-logo.png">`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** Siteimprove Alfa — `sia-r2` ([reference](https://alfa.siteimprove.com/rules/sia-r2))  
**Severity:** Moderate  
**Frequency:** 25 instances; 25 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (9 weeks)

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

### Steps to reproduce
1. Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html.
2. Locate the element: <img src="cms-site-logo.png">
3. Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

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

### Affected pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://www.cms.gov/priorities/electronic-prior-authorization/overview
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0125.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0131.html
- http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0253.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0432.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1920.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0221.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1890.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0197.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0953.html
- http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0087.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0307.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0195.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0409.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1746.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0052.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0098.html
- http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0288.html

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

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

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

### Example pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://www.cms.gov/priorities/electronic-prior-authorization/overview
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html

---

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

**Bug ID:** `VS-be245804`  
**Pattern ID:** `VS-a0bdbdf6`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=33  
**XPath / selector:** `#lblCmsNationalCoveragePolicy > ul:nth-child(2)`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `list` ([reference](https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1760 instances; 378 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<ul>10 Certification and Recertification by Physicians for Hospital Services - General</ul>
```

### Description
<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 378 of 6702 scanned pages (1760 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=33.
2. Locate the element: #lblCmsNationalCoveragePolicy > ul:nth-child(2)
3. Confirm the axe-core finding for rule list against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39857&sortBy=relevance&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33818&lcdStatus=all&sortBy=title&ver=15
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55265&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=13
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39726&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58801&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=73
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39284&lcdStatus=all&sortBy=title&ver=11
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34399&lcdStatus=all&sortBy=title&ver=30
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33624&lcdStatus=all&sortBy=title&stateRegion=all&ver=34
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58993&articleStatus=all&bc=3&sortBy=title&ver=16
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33967&lcdStatus=all&sortBy=title&ver=25
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38968&lcdStatus=all&sortBy=title&stateRegion=all&ver=5
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56865&ver=28
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33671&lcdStatus=all&sortBy=title&stateRegion=all&ver=48
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=311&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56680&ver=44
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33583&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57065&articleStatus=all&bc=3&sortBy=title&ver=32
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=32
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33396&lcdStatus=all&sortBy=title&ver=10
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56008&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33631&lcdStatus=all&sortBy=title&ver=51

…and more — 378 pages total ([download CSV](csv/axe-core__list.csv)).

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

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39857&sortBy=relevance&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28

---

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

**Bug ID:** `VS-53f5b307`  
**Pattern ID:** `VS-6175596b`  
**URL:** https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?fromdb=true&NCAId=246  
**XPath / selector:** `li:nth-child(5) > ul > em > li`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `listitem` ([reference](https://dequeuniversity.com/rules/axe/4.12/listitem?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 15 instances; 5 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<li>   Describe the capabilities of the study sites. </li>
```

### Description
<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 5 of 6702 scanned pages (15 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?fromdb=true&NCAId=246.
2. Locate the element: li:nth-child(5) > ul > em > li
3. Confirm the axe-core finding for rule listitem against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?fromdb=true&NCAId=246
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=296&proposed=N
- https://www.cms.gov/medicare-coverage-database/details/nca-view-public-comments.aspx?NCAId=295
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=264
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=247&proposed=N

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

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?fromdb=true&NCAId=246
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=296&proposed=N
- https://www.cms.gov/medicare-coverage-database/details/nca-view-public-comments.aspx?NCAId=295

---

## Table cell headers attributes must refer to other <th> elements in the same tabl (WCAG 1.3.1)

**Bug ID:** `VS-b5046566`  
**Pattern ID:** `VS-07ba3b17`  
**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`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `td-headers-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/td-headers-attr?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2 instances; 2 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (9 weeks)

### HTML snippet
```html
<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
1. Open https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=14&sort=asc.
2. Locate the element: .MsoTableGrid
3. 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
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=14&sort=asc
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_subject_formatted&sort=desc

### 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

### Example pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=14&sort=asc
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_subject_formatted&sort=desc

---

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

**Bug ID:** `VS-febe0850`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28  
**XPath / selector:** `<ul>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r68` ([reference](https://alfa.siteimprove.com/rules/sia-r68))  
**Severity:** Moderate  
**Frequency:** 424 instances; 113 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### 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
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28.
2. Locate the element: <ul>
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56865&ver=28
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=32
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37166&lcdStatus=all&sortBy=title&ver=23
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=40249&lcdStatus=all&sortBy=title&stateRegion=all&ver=5
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33575&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33944&lcdStatus=all&sortBy=title&stateRegion=all&ver=26
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36920&lcdStatus=all&sortBy=title&ver=107
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34163&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=34633&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33633&lcdStatus=all&sortBy=title&stateRegion=all&ver=49
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35006&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=35000&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39956&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35130&lcdStatus=all&sortBy=title&ver=66
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33733&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39464&sortBy=relevance
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=34181&ver=28
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=38745&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39513&lcdStatus=all&sortBy=title&stateRegion=all
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38992&lcdStatus=all&sortBy=title&ver=14
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33399&lcdStatus=all&sortBy=title

…and more — 113 pages total ([download CSV](csv/alfa__sia-r68.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-r68

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19

---

## Element has required aria-owns (WCAG 1.3.1)

**Bug ID:** `VS-de399084`  
**Pattern ID:** `VS-4408605e`  
**URL:** https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20  
**XPath / selector:** `<th scope="col">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r46` ([reference](https://alfa.siteimprove.com/rules/sia-r46))  
**Severity:** Moderate  
**Frequency:** 69 instances; 41 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (9 weeks)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 41 of 6702 scanned pages (69 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20.
2. Locate the element: <th scope="col">
3. Confirm the Siteimprove Alfa finding for rule sia-r46 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56802&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=15
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57207&articleStatus=all&bc=3&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57037&articleStatus=all&bc=3&sortBy=title&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53017&articleStatus=all&bc=3&sortBy=title&ver=34
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58116&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=28
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59620&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52432&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57614&articleStatus=all&bc=3&sortBy=title&ver=15
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58138&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=20
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57311&ver=32
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54117&ver=86
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57342&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56809&articleStatus=all&bc=3&sortBy=title&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57306&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=36
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57069&ver=22
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52437&articleStatus=all&bc=3&sortBy=title&ver=17
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57682&articleStatus=all&bc=3&sortBy=title&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59553&articleStatus=all&bc=3&sortBy=title&ver=3
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57284&ver=13
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56850&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=29
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57052&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=18
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57843&articleStatus=all&bc=3&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57804&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=41

…and more — 41 pages total ([download CSV](csv/alfa__sia-r46.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-r46

### Example pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56802&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=15
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39

---

## Element has required owned roles (WCAG 1.3.1)

**Bug ID:** `VS-453b3336`  
**Pattern ID:** `VS-3c632d31`  
**URL:** https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html  
**XPath / selector:** `<h1>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r64` ([reference](https://alfa.siteimprove.com/rules/sia-r64))  
**Severity:** Moderate  
**Frequency:** 32 instances; 30 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Steps to reproduce
1. Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html.
2. Locate the element: <h1>
3. Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59632&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=22
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37578&lcdStatus=all&sortBy=title&stateRegion=all&ver=28
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0125.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0131.html
- http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0253.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0432.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1920.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0221.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1890.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0197.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0953.html
- http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0087.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=60152&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1209&ver=4
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0307.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=59487&ver=14
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0195.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59632&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=19
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0409.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37244&lcdStatus=all&sortBy=title&stateRegion=all&ver=39

…and more — 30 pages total ([download CSV](csv/alfa__sia-r64.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-r64

### Example pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59632&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=22
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html

---

## Table cell has header (WCAG 1.3.1)

**Bug ID:** `VS-f0137535`  
**Pattern ID:** `VS-3f067795`  
**URL:** https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=90&proposed=Y  
**XPath / selector:** `<td colspan="4">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r77` ([reference](https://alfa.siteimprove.com/rules/sia-r77))  
**Severity:** Moderate  
**Frequency:** 9 instances; 2 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 2 of 6702 scanned pages (9 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=90&proposed=Y.
2. Locate the element: <td colspan="4">
3. Confirm the Siteimprove Alfa finding for rule sia-r77 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=90&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=76

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=90&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=76

---

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

**Bug ID:** `VS-0be23131`  
**Pattern ID:** `VS-0ddc2ac6`  
**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">`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r42` ([reference](https://alfa.siteimprove.com/rules/sia-r42))  
**Severity:** Moderate  
**Frequency:** 5 instances; 1 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (5 weeks)

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

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

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

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

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

---

## aria-hidden element is not exposed to assistive technology (WCAG 1.3.1)

**Bug ID:** `VS-37b62026`  
**Pattern ID:** `VS-9207ed51`  
**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"`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r45` ([reference](https://alfa.siteimprove.com/rules/sia-r45))  
**Severity:** Moderate  
**Frequency:** 13 instances; 1 of 6702 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W33 (6 weeks)

### 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
1. Open https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=14&sort=asc.
2. Locate the element: @headers="view-field-dyna-release-date-table-column"
3. 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
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=14&sort=asc

### 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

---

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

**Bug ID:** `VS-7e205bc5`  
**Pattern ID:** `VS-8ade3360`  
**URL:** https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?++=&bc=ABAAAAAAIAAA&NCAId=299&NCDId=281&ncdver=5&type=Open  
**XPath / selector:** `#lblCrossReference > a`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** axe-core — `link-in-text-block` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-in-text-block?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1526 instances; 669 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<a href="https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?NCDId=167&ncdver=1">
```

### Description
Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 669 of 6702 scanned pages (1526 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?++=&bc=ABAAAAAAIAAA&NCAId=299&NCDId=281&ncdver=5&type=Open.
2. Locate the element: #lblCrossReference > a
3. Confirm the axe-core finding for rule link-in-text-block against WCAG 1.4.1 Use of Color.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?++=&bc=ABAAAAAAIAAA&NCAId=299&NCDId=281&ncdver=5&type=Open
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39857&sortBy=relevance&ver=7
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35906&lcdStatus=all&sortBy=title&ver=25
- http://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=281
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59529&ver=9
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38613&lcdStatus=all&sortBy=title&ver=14
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34211&lcdStatus=all&sortBy=title&ver=37
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38176&lcdStatus=all&sortBy=title&ver=11
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40333&proposedStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36859&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- http://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=263
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39726&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39284&lcdStatus=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=71
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39840&lcdStatus=all&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39080&lcdStatus=all&sortBy=title&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38904&lcdStatus=all&sortBy=title&stateRegion=all&ver=11
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39270&lcdStatus=all&sortBy=title&ver=8
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38968&lcdStatus=all&sortBy=title&stateRegion=all&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39060&lcdStatus=all&sortBy=title&ver=15

…and more — 669 pages total ([download CSV](csv/axe-core__link-in-text-block.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/details/ncd-details.aspx?++=&bc=ABAAAAAAIAAA&NCAId=299&NCDId=281&ncdver=5&type=Open
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39857&sortBy=relevance&ver=7
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35906&lcdStatus=all&sortBy=title&ver=25

---

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

**Bug ID:** `VS-2c656955`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35936&lcdStatus=all&sortBy=title&ver=46  
**XPath / selector:** `<a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_2">`  
**WCAG SC:** 1.4.1 — Use of Color (Level A)  
**Rule:** Siteimprove Alfa — `sia-r62` ([reference](https://alfa.siteimprove.com/rules/sia-r62))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (9 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 1 of 6702 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35936&lcdStatus=all&sortBy=title&ver=46.
2. Locate the element: <a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_2">
3. Confirm the Siteimprove Alfa finding for rule sia-r62 against WCAG 1.4.1 Use of Color.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35936&lcdStatus=all&sortBy=title&ver=46

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

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

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

---

## Scrollable region must have keyboard access (WCAG 2.1.1)

**Bug ID:** `VS-51458e1b`  
**Pattern ID:** `VS-c613c153`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=311&proposed=Y  
**XPath / selector:** `pre`  
**WCAG SC:** 2.1.1 — Keyboard (Level A)  
**Rule:** axe-core — `scrollable-region-focusable` ([reference](https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2 instances; 2 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (6 weeks)

### HTML snippet
```html
<pre>TO: 		 Administrative File: &nbsp;CAG-00085R8 

FROM:		Coverage and Analysis Group (CAG)

SUBJECT: 	Proposed National Coverage Determination for Percutaneous Transluminal Angioplasty (PTA) of the
```

### Description
Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 2 of 6702 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=311&proposed=Y.
2. Locate the element: pre
3. Confirm the axe-core finding for rule scrollable-region-focusable against WCAG 2.1.1 Keyboard.

### Impact
Affects Without vision (1.0%), Limited manipulation/strength (13.0%), Limited reach (2.0%).
- **Without vision** (1.0% of population)
- **Limited manipulation/strength** (13.0% of population)
- **Limited reach** (2.0% of population)

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=311&proposed=Y
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=311&proposed=Y&sortBy=status&status=all

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

### Suggested fix
**How to fix:** Make scrollable regions keyboard-focusable (tabindex="0") so keyboard users can scroll them.

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=311&proposed=Y
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=311&proposed=Y&sortBy=status&status=all

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-fa279db0`  
**Pattern ID:** `VS-e9fe47ac`  
**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)`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** axe-core — `link-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 6 instances; 3 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<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
1. Open https://www.cms.gov/medicare/medicare-contracting/medicare-administrative-contractors/archive-j11-now-known-as-jurisdiction-m.
2. Locate the element: a[data-entity-type="node"][data-entity-substitution="canonical"][data-once="linkMatch"]:nth-child(1)
3. Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

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

### Affected pages
- https://www.cms.gov/medicare/medicare-contracting/medicare-administrative-contractors/archive-j11-now-known-as-jurisdiction-m
- https://www.cms.gov/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs10
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments

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

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

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

### Example pages
- https://www.cms.gov/medicare/medicare-contracting/medicare-administrative-contractors/archive-j11-now-known-as-jurisdiction-m
- https://www.cms.gov/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs10
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments

---

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

**Bug ID:** `VS-17dca749`  
**Pattern ID:** `VS-c126b6a6`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html  
**XPath / selector:** `html`  
**WCAG SC:** 3.1.1 — Language of Page (Level A)  
**Rule:** axe-core — `html-has-lang` ([reference](https://dequeuniversity.com/rules/axe/4.12/html-has-lang?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 127 instances; 127 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
2. Locate the element: html
3. Confirm the axe-core finding for rule html-has-lang against WCAG 3.1.1 Language of Page.

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0056.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1137.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1905.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0165.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0296.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1245.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0395.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0053.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0026.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0126.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0338.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0020.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0017.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0280.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0011.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0035.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0381.html

…and more — 127 pages total ([download CSV](csv/axe-core__html-has-lang.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").

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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0056.html

---

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

**Bug ID:** `VS-73eea048`  
**Pattern ID:** `VS-7a0e5645`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html  
**XPath / selector:** `<html>`  
**WCAG SC:** 3.1.1 — Language of Page (Level A)  
**Rule:** Siteimprove Alfa — `sia-r4` ([reference](https://alfa.siteimprove.com/rules/sia-r4))  
**Severity:** Moderate  
**Frequency:** 28 instances; 28 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### 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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
2. Locate the element: <html>
3. Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page.

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0125.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0131.html
- http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0253.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0432.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1920.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0221.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1890.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1070.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0197.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0953.html
- http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0087.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0307.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0195.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0409.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1746.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0340.html

…and more — 28 pages total ([download CSV](csv/alfa__sia-r4.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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html

---

## Form elements must have labels (WCAG 4.1.2)

**Bug ID:** `VS-6287d1e8`  
**Pattern ID:** `VS-fafffee0`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html  
**XPath / selector:** `#q`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `label` ([reference](https://dequeuniversity.com/rules/axe/4.12/label?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 29 instances; 29 of 6702 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W33 (8 weeks)

### HTML snippet
```html
<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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
2. Locate the element: #q
3. 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
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1137.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1245.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0395.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0725.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0600.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0708.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1126.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1140.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1486.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1070.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0200.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0184.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1215.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1163.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1193.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0401.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1184.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0358.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0381.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0143.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1170.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0078.html

…and more — 29 pages total ([download CSV](csv/axe-core__label.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.

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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1137.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html

---

## Elements must only use supported ARIA attributes (WCAG 4.1.2)

**Bug ID:** `VS-f6b01f33`  
**Pattern ID:** `VS-1467ea8a`  
**URL:** http://cms.gov/files/linked-video-files/new-features-medicare-gov  
**XPath / selector:** `a[title="Home"]`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `aria-allowed-attr` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 4 instances; 1 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (5 weeks)

### HTML snippet
```html
<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
1. Open http://cms.gov/files/linked-video-files/new-features-medicare-gov.
2. Locate the element: a[title="Home"]
3. 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
- http://cms.gov/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

---

## Interactive controls must not be nested (WCAG 4.1.2)

**Bug ID:** `VS-100743f3`  
**Pattern ID:** `VS-58301a87`  
**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`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `nested-interactive` ([reference](https://dequeuniversity.com/rules/axe/4.12/nested-interactive?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 6702 pages affected
  
**History:** first seen 2026-W33, last seen 2026-W33 (1 week)

### HTML snippet
```html
<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
1. Open http://cms.gov/files/linked-video-files/new-features-medicare-gov.
2. Locate the element: .ytPageHeaderViewModelScrollContainer > .ytPageHeaderViewModelContent > .ytPageHeaderViewModelHeadline > .ytPageHeaderViewModelHeadlineInfo > .ytPageHeaderViewModelContentMetadata.ytPageHeaderViewModelContentMetadataOverlay > .ytContentMetadataViewModelMetadataRow[role="group"]:nth-child(1) > yt-avatar-stack-view-model
3. 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
- http://cms.gov/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

---

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

**Bug ID:** `VS-d05344c9`  
**Pattern ID:** `VS-be8d563e`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=33  
**XPath / selector:** `em > span`  
**WCAG SC:** 1.4.3 — Contrast (Minimum) (Level AA)  
**Rule:** axe-core — `color-contrast` ([reference](https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 574 instances; 36 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<span style="color: red;"> (NCD) Manual</span>
```

### Description
Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 36 of 6702 scanned pages (574 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=33.
2. Locate the element: em > span
3. Confirm the axe-core finding for rule color-contrast against WCAG 1.4.3 Contrast (Minimum).

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33624&lcdStatus=all&sortBy=title&stateRegion=all&ver=34
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=311&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33393&lcdStatus=all&sortBy=title&stateRegion=all&ver=10
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33611&lcdStatus=all&sortBy=title&ver=25
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52487&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=27
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39462&lcdStatus=all&sortBy=title&ver=9
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52465&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=65
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=311&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=37897&ver=18
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=296&proposed=N
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=381&ncdver=1&sortBy=title
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=39936&proposedStatus=all&sortBy=title&stateRegion=all&ver=14
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=279&proposed=N&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33803&proposedStatus=all&sortBy=title&stateRegion=all&ver=57
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40269&proposedStatus=all&sortBy=title&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36706&lcdStatus=all&sortBy=title&stateRegion=all&ver=23
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52508&ver=39
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36706&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52465&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=60
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40270&proposedStatus=all&sortBy=title&stateRegion=all&ver=19
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=283&proposed=N
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33393&lcdStatus=all&sortBy=title&ver=10
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37921&lcdStatus=all&sortBy=title&stateRegion=all&ver=18
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33611&lcdStatus=all&sortBy=title&stateRegion=all&ver=25

…and more — 36 pages total ([download CSV](csv/axe-core__color-contrast.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:** Increase the contrast between text and its background to at least 4.5:1 (3:1 for large text). Check both light and dark modes.

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33624&lcdStatus=all&sortBy=title&stateRegion=all&ver=34
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=311&proposed=Y

---

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

**Bug ID:** `VS-b192767c`  
**Pattern ID:** `VS-f7e99f4b`  
**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"`  
**WCAG SC:** 1.4.3 — Contrast (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r69` ([reference](https://alfa.siteimprove.com/rules/sia-r69))  
**Severity:** Moderate  
**Frequency:** 50 instances; 9 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### 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
1. 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.
2. Locate the element: text: "Column I"
3. Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum).

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52487&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=27
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52465&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=65
- https://cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39475&lcdStatus=all&sortBy=title&ver=7
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40270&proposedStatus=all&sortBy=title&stateRegion=all&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33611&lcdStatus=all&sortBy=title&stateRegion=all&ver=25
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33828&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52465&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=72
- https://www.cms.gov/priorities/innovation/innovation-models/Bundled-Payments

### 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

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52487&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=27
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52465&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=65
- https://cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation

---

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

**Bug ID:** `VS-8f470a84`  
**Pattern ID:** `VS-dd1c019f`  
**URL:** https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings  
**XPath / selector:** `a[href$="#_ftnref1"] > span[lang="X-NONE"]`  
**WCAG SC:** 3.1.2 — Language of Parts (Level AA)  
**Rule:** axe-core — `valid-lang` ([reference](https://dequeuniversity.com/rules/axe/4.12/valid-lang?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Description
lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 6702 scanned pages (1 instances).

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

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

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

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

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

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-48e7b48f`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19  
**XPath / selector:** `text: "Here's how you know"`  
**WCAG SC:** 1.4.6 — Contrast (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r66` ([reference](https://alfa.siteimprove.com/rules/sia-r66))  
**Severity:** Moderate  
**Frequency:** 2917 instances; 453 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 453 of 6702 scanned pages (2917 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19.
2. Locate the element: text: "Here's how you know"
3. Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40333&proposedStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36859&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35050&lcdStatus=all&sortBy=title&stateRegion=all&ver=55
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=334&ncdver=1&sortBy=title
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=292&ncdver=1&sortBy=title
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54899&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38904&lcdStatus=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52490&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=25
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55757&ver=5
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39270&lcdStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56865&ver=28
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37598&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40198&proposedStatus=all&sortBy=title&stateRegion=all&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=32
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=60348&articleStatus=all&bc=3&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57482&articleStatus=all&bc=3&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33575&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56802&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=15

…and more — 453 pages total ([download CSV](csv/alfa__sia-r66.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:** Increase text contrast to meet WCAG AAA (7:1).

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136

---

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

**Bug ID:** `VS-f53ec98f`  
**Pattern ID:** `VS-2208081b`  
**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">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r73` ([reference](https://alfa.siteimprove.com/rules/sia-r73))  
**Severity:** Moderate  
**Frequency:** 11341 instances; 829 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### 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
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19.
2. Locate the element: <p class="usa-banner__header-text">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- 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
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40333&proposedStatus=all&sortBy=title&ver=7
- https://cms.gov/contacts/west-virginia-insurance-commission/general-beneficiary-contact/1562561
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36859&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35050&lcdStatus=all&sortBy=title&stateRegion=all&ver=55
- http://www.cms.gov/ltch-webpricer
- http://www.cms.gov/newsroom/press-releases/proposed-medicare-rule-would-modernize-end-stage-renal-disease-conditions-coverage
- http://cms.gov/training-education/medicare-learning-networkr-mln/resources-training/mln-publications-multimedia
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- http://www.cms.gov/health-tech-ecosystem/early-adopters/conversational-ai-assistants
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=334&ncdver=1&sortBy=title
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=292&ncdver=1&sortBy=title
- https://www.cms.gov/medicare/payment/part-b-drugs/discarded-drugs
- http://cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-proposed-rule-home-page
- https://cms.gov/glossary?items_per_page=10&order=title&page=97&sort=asc&term=&viewmode=grid
- https://www.cms.gov/newsroom/press-releases/new-drug-coverage-south-carolina-include-options-additional-benefits-and-saving-money
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54899&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2017-transmittals-items/r171soma
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38904&lcdStatus=all&sortBy=title&stateRegion=all&ver=11

…and more — 829 pages total ([download CSV](csv/alfa__sia-r73.csv)).

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- 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

---

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

**Bug ID:** `VS-71afe19a`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19  
**XPath / selector:** `<p class="mb-2">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r74` ([reference](https://alfa.siteimprove.com/rules/sia-r74))  
**Severity:** Moderate  
**Frequency:** 32275 instances; 452 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 452 of 6702 scanned pages (32275 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19.
2. Locate the element: <p class="mb-2">
3. Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40333&proposedStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36859&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35050&lcdStatus=all&sortBy=title&stateRegion=all&ver=55
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=334&ncdver=1&sortBy=title
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=292&ncdver=1&sortBy=title
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54899&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38904&lcdStatus=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52490&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=25
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55757&ver=5
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39270&lcdStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56865&ver=28
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37598&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40198&proposedStatus=all&sortBy=title&stateRegion=all&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=32
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=60348&articleStatus=all&bc=3&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57482&articleStatus=all&bc=3&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33575&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56802&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=15

…and more — 452 pages total ([download CSV](csv/alfa__sia-r74.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-r74

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136

---

## Scrollable element is keyboard accessible (WCAG 1.4.8)

**Bug ID:** `VS-d67cd18a`  
**Pattern ID:** `VS-388b5438`  
**URL:** http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20  
**XPath / selector:** `<p style="line-height: 11.55pt;">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r80` ([reference](https://alfa.siteimprove.com/rules/sia-r80))  
**Severity:** Moderate  
**Frequency:** 786 instances; 42 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (9 weeks)

### Description
Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 42 of 6702 scanned pages (786 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20.
2. Locate the element: <p style="line-height: 11.55pt;">
3. 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
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=32
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37475&lcdStatus=all&sortBy=title&ver=18
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37608&lcdStatus=all&sortBy=title&ver=22
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38705&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38994&lcdStatus=all&sortBy=title&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52465&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=65
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58720&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=68
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57868&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38992&lcdStatus=all&sortBy=title&ver=14
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38992&lcdStatus=all&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34372&lcdStatus=all&sortBy=title&stateRegion=all&ver=22
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38566&ver=11
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38339&lcdStatus=all&sortBy=title&stateRegion=all&ver=17
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52481&articleStatus=all&bc=3&sortBy=title&ver=30
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39575&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37295&lcdStatus=all&sortBy=title&ver=22
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38111&lcdStatus=all&sortBy=title&stateRegion=all&ver=10
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58713&ver=13
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38584&lcdStatus=all&sortBy=title&ver=15
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&stateRegion=all&ver=26
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58185&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38745&lcdStatus=all&sortBy=title&stateRegion=all&ver=17
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58343&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56231&articleStatus=all&bc=3&sortBy=title&ver=3

…and more — 42 pages total ([download CSV](csv/alfa__sia-r80.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-r80

### Example pages
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=32
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37475&lcdStatus=all&sortBy=title&ver=18

---

## iframe element is not empty (WCAG 1.4.8)

**Bug ID:** `VS-e8ca617d`  
**Pattern ID:** `VS-48291402`  
**URL:** http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20  
**XPath / selector:** `<p style="text-align: justify;">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r71` ([reference](https://alfa.siteimprove.com/rules/sia-r71))  
**Severity:** Moderate  
**Frequency:** 673 instances; 29 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (9 weeks)

### Description
iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 29 of 6702 scanned pages (673 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20.
2. Locate the element: <p style="text-align: justify;">
3. Confirm the Siteimprove Alfa finding for rule sia-r71 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=32
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38994&lcdStatus=all&sortBy=title&ver=20
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56240&articleStatus=all&bc=3&sortBy=title&ver=8
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57868&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36044&lcdStatus=all&sortBy=title&ver=58
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38649&lcdStatus=all&sortBy=title&ver=13
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38339&lcdStatus=all&sortBy=title&stateRegion=all&ver=17
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39276&lcdStatus=all&sortBy=title&ver=9
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38111&lcdStatus=all&sortBy=title&stateRegion=all&ver=10
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&stateRegion=all&ver=26
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56239&articleStatus=all&bc=3&sortBy=title&ver=3
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58185&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=33794&proposedStatus=all&sortBy=title&ver=157
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56231&articleStatus=all&bc=3&sortBy=title&ver=3
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=39835&proposedStatus=all&sortBy=title&stateRegion=all&ver=10
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38920&lcdStatus=all&sortBy=title&ver=16
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39799&ver=15
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38026&lcdStatus=all&sortBy=title&stateRegion=all&ver=28
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=60152&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1209&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58181&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39741&lcdStatus=all&sortBy=title&ver=8
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38803&lcdStatus=all&sortBy=title&ver=17
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39005&lcdStatus=all&sortBy=title&stateRegion=all&ver=9

…and more — 29 pages total ([download CSV](csv/alfa__sia-r71.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-r71

### Example pages
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=32
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38994&lcdStatus=all&sortBy=title&ver=20

---

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

**Bug ID:** `VS-df141fc5`  
**Pattern ID:** `VS-cb53cc4d`  
**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">`  
**WCAG SC:** 2.5.5 — Target Size (Enhanced) (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r111` ([reference](https://alfa.siteimprove.com/rules/sia-r111))  
**Severity:** Moderate  
**Frequency:** 26567 instances; 838 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### 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
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19.
2. Locate the element: <a href="#h3LcdGuidanceHeader" data-href="h3LcdGuidanceHeader" class="nav-link toc-link no-link log-click" title="Jump to Coverage Guidance">
3. Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- 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
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40333&proposedStatus=all&sortBy=title&ver=7
- https://cms.gov/contacts/west-virginia-insurance-commission/general-beneficiary-contact/1562561
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36859&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35050&lcdStatus=all&sortBy=title&stateRegion=all&ver=55
- http://www.cms.gov/ltch-webpricer
- http://www.cms.gov/newsroom/press-releases/proposed-medicare-rule-would-modernize-end-stage-renal-disease-conditions-coverage
- http://cms.gov/training-education/medicare-learning-networkr-mln/resources-training/mln-publications-multimedia
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- http://www.cms.gov/health-tech-ecosystem/early-adopters/conversational-ai-assistants
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=334&ncdver=1&sortBy=title
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=292&ncdver=1&sortBy=title
- https://www.cms.gov/medicare/payment/part-b-drugs/discarded-drugs
- http://cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-proposed-rule-home-page
- https://cms.gov/glossary?items_per_page=10&order=title&page=97&sort=asc&term=&viewmode=grid
- https://www.cms.gov/newsroom/press-releases/new-drug-coverage-south-carolina-include-options-additional-benefits-and-saving-money
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54899&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2017-transmittals-items/r171soma

…and more — 838 pages total ([download CSV](csv/alfa__sia-r111.csv)).

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- 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

---

## accesskey attribute value should be unique (WCAG criterion undetermined)

**Bug ID:** `VS-9e10d04e`  
**Pattern ID:** `VS-bd13f00a`  
**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"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `accesskeys` ([reference](https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 113 instances; 39 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (7 weeks)

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

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

### Affected pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0026.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0126.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0338.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0020.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0017.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0011.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0035.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0011.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0009.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0125.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0029.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0221.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0563.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0568.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0183.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0306.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0487.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0188.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0197.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0578.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0030.html

…and more — 39 pages total ([download CSV](csv/axe-core__accesskeys.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

### Example pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0026.html

---

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

**Bug ID:** `VS-0813c0bb`  
**Pattern ID:** `VS-d25f622d`  
**URL:** http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=39905&lcdStatus=all&sortBy=title  
**XPath / selector:** `#navStickyHeader`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 294 instances; 290 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<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
1. Open http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=39905&lcdStatus=all&sortBy=title.
2. Locate the element: #navStickyHeader
3. Confirm the axe-core finding for rule heading-order.

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

### Affected pages
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=39905&lcdStatus=all&sortBy=title
- https://cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/application-types-timeline
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37857&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37870&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/newsroom/press-releases/cms-launches-second-phase-consumer-education-long-term-care
- https://cms.gov/priorities/innovation/innovation-models/tmah
- https://www.cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=1&mcdid=27&sortBy=title&status=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=38331&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=311&proposed=Y
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=40048&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36951&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33941&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35702&lcdStatus=all&sortBy=title
- http://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33563&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/application-types-timeline
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=35175&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=36362&sortBy=relevance
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=34434&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=39995&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=40289&lcdStatus=all&sortBy=title
- https://www.cms.gov/apps/ama/license.asp?file=%2FResearch-Statistics-Data-and-Systems%2FDownloadable-Public-Use-Files%2FPart-B-Carrier-Summary-Data-File%2FDownloads%2F2005AllCarriers.zip
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33575&lcdStatus=all&sortBy=title&stateRegion=all
- http://www.cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-state-report.aspx?contractorNumber=all&lcdid=40139&proposedStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38288&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38972&lcdStatus=all&sortBy=title

…and more — 290 pages total ([download CSV](csv/axe-core__heading-order.csv)).

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

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

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

### Example pages
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=39905&lcdStatus=all&sortBy=title
- https://cms.gov/medicare/payment/fee-for-service-providers/shared-savings-program-ssp-acos/application-types-timeline
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37857&lcdStatus=all&sortBy=title&stateRegion=all

---

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

**Bug ID:** `VS-846ac887`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html  
**XPath / selector:** `.hhshead[cellpadding="0"][cellspacing="0"]:nth-child(1)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 2279 instances; 128 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
2. Locate the element: .hhshead[cellpadding="0"][cellspacing="0"]:nth-child(1)
3. Confirm the axe-core finding for rule region.

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0056.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html
- https://www.cms.gov/priorities/electronic-prior-authorization/overview
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1137.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1905.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0165.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0296.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1245.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0395.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0053.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0026.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0126.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0338.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0020.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0017.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0280.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0011.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0035.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html

…and more — 128 pages total ([download CSV](csv/axe-core__region.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.

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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0056.html

---

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

**Bug ID:** `VS-41df8942`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-one-main` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 127 instances; 127 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
2. Locate the element: html
3. Confirm the axe-core finding for rule landmark-one-main.

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0056.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1137.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1905.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0165.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0296.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1245.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0395.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0053.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0026.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0126.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0338.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0020.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0017.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0280.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0011.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0035.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0381.html

…and more — 127 pages total ([download CSV](csv/axe-core__landmark-one-main.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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0056.html

---

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

**Bug ID:** `VS-a90d129c`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html  
**XPath / selector:** `html`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `page-has-heading-one` ([reference](https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 42 instances; 42 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
2. Locate the element: html
3. Confirm the axe-core finding for rule page-has-heading-one.

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1137.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1245.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0395.html
- https://www.cms.gov/medicaid-chip/community-engagement-support/eligibility-made-easy
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0725.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0600.html
- https://www.cms.gov/derechos-facturas-medicas/ayuda/guias/explicacion-de-beneficios
- https://www.cms.gov/data-research/cms-information-technology/tlc
- https://cms.gov/priorities/medicare-prescription-drug-affordability/overview/medicare-drug-price-negotiation-program
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0708.html
- https://www.cms.gov/medical-bill-rights/help/guides/bill-errors
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1126.html
- https://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1140.html
- https://www.cms.gov/medical-bill-rights/help/guides/how-to-read-bill
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1486.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1070.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0200.html
- https://www.cms.gov/medical-bill-rights/help
- https://www.cms.gov/medical-bill-rights/help/guides
- https://www.cms.gov/medical-bill-rights
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0184.html

…and more — 42 pages total ([download CSV](csv/axe-core__page-has-heading-one.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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1137.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html

---

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

**Bug ID:** `VS-fba107ff`  
**Pattern ID:** `VS-0ba8ce9d`  
**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"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `scope-attr-valid` ([reference](https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 428 instances; 22 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?fromdb=true&NCAId=246
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=16
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=364&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=160&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=79&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38571&lcdStatus=all&sortBy=title&ver=9
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1126.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=77&proposed=N
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1070.html
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=90&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=283&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=160&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=281&proposed=Y
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=264
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=195&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=279&proposed=Y&type=Closed
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=331&ncdver=4&sortBy=title
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=258
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=109&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=260&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=211&ncdver=2
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=247&proposed=N

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?fromdb=true&NCAId=246
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=16
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=364&ncdver=1&sortBy=title

---

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

**Bug ID:** `VS-e029d9da`  
**Pattern ID:** `VS-30db094d`  
**URL:** https://cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation  
**XPath / selector:** `.Header`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-banner-is-top-level` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 2 instances; 2 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (7 weeks)

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

### Description
Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 2 of 6702 scanned pages (2 instances).

### Steps to reproduce
1. Open https://cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation.
2. Locate the element: .Header
3. Confirm the axe-core finding for rule landmark-banner-is-top-level.

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

### Affected pages
- https://cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation
- http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html

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

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

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

### Example pages
- https://cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation
- http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html

---

## Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined)

**Bug ID:** `VS-1275e590`  
**Pattern ID:** `VS-8806389c`  
**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"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (9 weeks)

### HTML snippet
```html
<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
1. Open https://cms.gov/priorities/health-equity/minority-health/resource-center/webinars-trainings/coverage-care-c2c-webinars.
2. 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"]
3. Confirm the axe-core finding for rule landmark-unique.

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

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

---

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

**Bug ID:** `VS-e7dcc132`  
**Pattern ID:** `VS-0066c67d`  
**URL:** https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html  
**XPath / selector:** `h1:nth-child(2)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `empty-heading` ([reference](https://dequeuniversity.com/rules/axe/4.12/empty-heading?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 113 instances; 109 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### HTML snippet
```html
<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
1. Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html.
2. Locate the element: h1:nth-child(2)
3. Confirm the axe-core finding for rule empty-heading.

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

### Affected pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0056.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1905.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0165.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0296.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0053.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0026.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59632&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=22
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0126.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0338.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0020.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37578&lcdStatus=all&sortBy=title&stateRegion=all&ver=28
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0017.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0280.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0011.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0035.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0381.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0064.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0011.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0009.html
- http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0014.html

…and more — 109 pages total ([download CSV](csv/axe-core__empty-heading.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:** Remove empty headings or give them text. Don't use heading tags for spacing.

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

### Example pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0056.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0005.html

---

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

**Bug ID:** `VS-3a6ca9c2`  
**Pattern ID:** `VS-d69fc059`  
**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`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `empty-table-header` ([reference](https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 21 instances; 16 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36889&lcdStatus=all&sortBy=title&ver=24
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=294
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=16
- https://www.cms.gov/medicare/medicare-fee-for-service-payment/sharedsavingsprogram/application-information
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=279&proposed=N&sortBy=status&status=all
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1126.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36889&lcdStatus=all&sortBy=title&ver=25
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=77&proposed=N
- https://www.cms.gov/medicare-coverage-database/details/medcac-meeting-details.aspx?bc=AAAIAAAAAAAA&MEDCACId=76
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1070.html
- https://cms.gov/newsroom/fact-sheets/2025-medicare-parts-b-premiums-and-deductibles
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=279&proposed=Y&type=Closed
- http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=297
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=76
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36889&lcdStatus=all&sortBy=title&stateRegion=all&ver=25
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=295

### 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

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36889&lcdStatus=all&sortBy=title&ver=24
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=294
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=16

---

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

**Bug ID:** `VS-a033b296`  
**Pattern ID:** `VS-7118fead`  
**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`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r61` ([reference](https://alfa.siteimprove.com/rules/sia-r61))  
**Severity:** Moderate  
**Frequency:** 809 instances; 809 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r61.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- 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
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=136
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40333&proposedStatus=all&sortBy=title&ver=7
- https://cms.gov/contacts/west-virginia-insurance-commission/general-beneficiary-contact/1562561
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36859&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35050&lcdStatus=all&sortBy=title&stateRegion=all&ver=55
- http://www.cms.gov/ltch-webpricer
- http://www.cms.gov/newsroom/press-releases/proposed-medicare-rule-would-modernize-end-stage-renal-disease-conditions-coverage
- http://cms.gov/training-education/medicare-learning-networkr-mln/resources-training/mln-publications-multimedia
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- http://www.cms.gov/health-tech-ecosystem/early-adopters/conversational-ai-assistants
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=334&ncdver=1&sortBy=title
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=292&ncdver=1&sortBy=title
- https://www.cms.gov/medicare/payment/part-b-drugs/discarded-drugs
- http://cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-proposed-rule-home-page
- https://cms.gov/glossary?items_per_page=10&order=title&page=97&sort=asc&term=&viewmode=grid
- https://www.cms.gov/newsroom/press-releases/new-drug-coverage-south-carolina-include-options-additional-benefits-and-saving-money
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54899&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2017-transmittals-items/r171soma
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38904&lcdStatus=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52490&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=25

…and more — 809 pages total ([download CSV](csv/alfa__sia-r61.csv)).

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- 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

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-c4ca0898`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19  
**XPath / selector:** `<h3 id="h3DocumentInformationHeader" class="document-view-section-header">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 423 instances; 422 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 422 of 6702 scanned pages (423 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19.
2. Locate the element: <h3 id="h3DocumentInformationHeader" class="document-view-section-header">
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40333&proposedStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36859&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35050&lcdStatus=all&sortBy=title&stateRegion=all&ver=55
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38994&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54899&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38904&lcdStatus=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52490&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=25
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39270&lcdStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56865&ver=28
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37598&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40198&proposedStatus=all&sortBy=title&stateRegion=all&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=32
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=60348&articleStatus=all&bc=3&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57482&articleStatus=all&bc=3&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33575&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56802&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=15
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57207&articleStatus=all&bc=3&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57037&articleStatus=all&bc=3&sortBy=title&ver=20
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36351&lcdStatus=all&sortBy=title&ver=36

…and more — 422 pages total ([download CSV](csv/alfa__sia-r53.csv)).

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

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38223&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=35098&lcdStatus=all&sortBy=title&ver=28
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40333&proposedStatus=all&sortBy=title&ver=7

---

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

**Bug ID:** `VS-8cdd5dcf`  
**Pattern ID:** `VS-c18be945`  
**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"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 249 instances; 248 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### 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
1. 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.
2. Locate the element: text: "Feedback"
3. Confirm the Siteimprove Alfa finding for rule sia-r57.

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

### Affected pages
- https://www.cms.gov/priorities/innovation-center/value-based-care-spotlight/patient-provider-voices/whole-person-care-stories/improving-health-access-care-rural-areas-one-pennsylvania-couples-story
- https://cms.gov/contacts/west-virginia-insurance-commission/general-beneficiary-contact/1562561
- http://www.cms.gov/ltch-webpricer
- http://cms.gov/training-education/medicare-learning-networkr-mln/resources-training/mln-publications-multimedia
- http://www.cms.gov/health-tech-ecosystem/early-adopters/conversational-ai-assistants
- https://www.cms.gov/medicare/payment/part-b-drugs/discarded-drugs
- http://cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/fy-2026-ipps-proposed-rule-home-page
- https://cms.gov/glossary?items_per_page=10&order=title&page=97&sort=asc&term=&viewmode=grid
- https://www.cms.gov/newsroom/press-releases/new-drug-coverage-south-carolina-include-options-additional-benefits-and-saving-money
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2017-transmittals-items/r171soma
- https://www.cms.gov/priorities/electronic-prior-authorization/overview
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r11670cp
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_issue_date&page=3&sort=desc
- https://www.cms.gov/medicare/coverage/determination-process/local
- https://www.cms.gov/priorities/innovation/innovation-models/medicare-demonstrations/demonstration-project-for-medical-adult-day-care-services
- https://www.cms.gov/newsroom/press-releases/more-people-medicare-receiving-free-preventive-care
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2013-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=9&sort=desc
- https://cms.gov/training-education/partner-outreach-resources/american-indian-alaska-native/ltss-ta-center/information/ltss-models/home-and-community-based-services
- https://www.cms.gov/marketplace/about/exchange-coverage-maps
- http://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_implementation_date&sort=asc
- https://cms.gov/regulations-and-guidanceguidancetransmittals2020-transmittals/r4532cp
- https://cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals?items_per_page=25&order=field_dyna_issue_date&page=8&sort=desc
- http://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/mln-publications-items/cms1243319
- https://www.cms.gov/newsroom/press-releases/speech-remarks-administrator-seema-verma-blue-button-developer-conference
- https://cms.gov/newsroom/press-releases/obama-administration-offers-states-new-ways-improve-care-lower-costs-medicaid

…and more — 248 pages total ([download CSV](csv/alfa__sia-r57.csv)).

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

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

### Example pages
- https://www.cms.gov/priorities/innovation-center/value-based-care-spotlight/patient-provider-voices/whole-person-care-stories/improving-health-access-care-rural-areas-one-pennsylvania-couples-story
- https://cms.gov/contacts/west-virginia-insurance-commission/general-beneficiary-contact/1562561
- http://www.cms.gov/ltch-webpricer

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-73f4fb49`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html  
**XPath / selector:** `<h1>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r78` ([reference](https://alfa.siteimprove.com/rules/sia-r78))  
**Severity:** Moderate  
**Frequency:** 245 instances; 173 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

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

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

### Affected pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56865&ver=28
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57482&articleStatus=all&bc=3&sortBy=title&ver=23
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56802&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=15
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57207&articleStatus=all&bc=3&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57037&articleStatus=all&bc=3&sortBy=title&ver=20
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54418&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=25
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53017&articleStatus=all&bc=3&sortBy=title&ver=34
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58503&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=12
- https://www.cms.gov/cms-l564-request-employment-information
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33575&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59060&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=3
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58116&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=28
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56793&articleStatus=all&bc=3&sortBy=title&ver=35
- https://www.cms.gov/
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=34633&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57972&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=10
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals/r13103cp
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59632&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=22
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56503&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=12
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0407.html
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35006&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=35000&lcdStatus=all&sortBy=title

…and more — 173 pages total ([download CSV](csv/alfa__sia-r78.csv)).

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

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

### Example pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0365.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56865&ver=28
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57718&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20

---

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

**Bug ID:** `VS-a1d378eb`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html  
**XPath / selector:** `img`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 441 instances; 25 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

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

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

### Steps to reproduce
1. Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html.
2. Locate the element: img
3. Confirm the deprecated-html finding for rule presentational-attr.

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

### Affected pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39462&lcdStatus=all&sortBy=title&ver=9
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=40334&proposedStatus=all&sortBy=title&ver=2
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0280.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0005.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37070&lcdStatus=all&sortBy=title&ver=26
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37887&lcdStatus=all&sortBy=title&ver=25
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1923.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38914&ver=20
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=37905&ver=18
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37356&lcdStatus=all&sortBy=title&ver=17
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=279&proposed=Y&type=Closed
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0401.html
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=331&ncdver=4&sortBy=title
- http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=297
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=76
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37919&lcdStatus=all&sortBy=title&ver=12
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58168&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=33
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55646&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39658&lcdStatus=all&sortBy=title&ver=4
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0317.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36707&lcdStatus=all&sortBy=title&ver=40
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39237&lcdStatus=all&sortBy=title&stateRegion=all&ver=10
- https://www.cms.gov/medicare-coverage-database/details/medcac-meeting-details.aspx?fromdb=true&MEDCACId=21
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=283&proposed=Y

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

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

### Example pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0595.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39462&lcdStatus=all&sortBy=title&ver=9
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=40334&proposedStatus=all&sortBy=title&ver=2

---

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

**Bug ID:** `VS-1b141c1d`  
**Pattern ID:** `VS-f2542d87`  
**URL:** https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=210&proposed=Y  
**XPath / selector:** `<pre>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r79` ([reference](https://alfa.siteimprove.com/rules/sia-r79))  
**Severity:** Moderate  
**Frequency:** 5 instances; 5 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (10 weeks)

### Description
Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 5 of 6702 scanned pages (5 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=210&proposed=Y.
2. Locate the element: <pre>
3. Confirm the Siteimprove Alfa finding for rule sia-r79.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=210&proposed=Y
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=90&proposed=Y
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=258
- https://www.cms.gov/medicare-coverage-database/details/cal-decision-memo.aspx?bc=BAgAAAAAgAAA&CALId=173&CalName=Hepatitis+Panel%2FAcute+Hepatitis+Pane+%28Addition+of+ICD-9-CM+790.4%2C++Elevation+of+Levels+of+Transaminase+or+Lactic+Acid+Dehydrogenase%29&fromdb=true&ver=10
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=283&proposed=Y

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=210&proposed=Y
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=90&proposed=Y
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=258

---

## Element with orientation is not locked (WCAG criterion undetermined)

**Bug ID:** `VS-7b742ef1`  
**Pattern ID:** `VS-7fbb8b20`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html  
**XPath / selector:** `{"type":"document","children":[{"type":"element","children":[{"type":"element","`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r59` ([reference](https://alfa.siteimprove.com/rules/sia-r59))  
**Severity:** Moderate  
**Frequency:** 4 instances; 4 of 6702 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W33 (8 weeks)

### 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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
2. Locate the element: {"type":"document","children":[{"type":"element","children":[{"type":"element","
3. Confirm the Siteimprove Alfa finding for rule sia-r59.

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1070.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-r59

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html

---

## Form field error is identified and described (WCAG criterion undetermined)

**Bug ID:** `VS-6bc59a90`  
**Pattern ID:** `VS-e43903a1`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html  
**XPath / selector:** `<ul id="globar">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r75` ([reference](https://alfa.siteimprove.com/rules/sia-r75))  
**Severity:** Moderate  
**Frequency:** 8 instances; 4 of 6702 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W33 (8 weeks)

### 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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html.
2. Locate the element: <ul id="globar">
3. Confirm the Siteimprove Alfa finding for rule sia-r75.

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1070.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-r75

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0918.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0017.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0248.html

---

## No obsolete or deprecated elements are used (WCAG criterion undetermined)

**Bug ID:** `VS-a2725611`  
**Pattern ID:** `VS-3d033717`  
**URL:** http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33942&lcdStatus=all&sortBy=title&stateRegion=all&ver=47  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r70` ([reference](https://alfa.siteimprove.com/rules/sia-r70))  
**Severity:** Moderate  
**Frequency:** 3 instances; 3 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (9 weeks)

### Description
No obsolete or deprecated elements are used. Detected by Siteimprove Alfa rule sia-r70 on 3 of 6702 scanned pages (3 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33942&lcdStatus=all&sortBy=title&stateRegion=all&ver=47.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r70.

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

### Affected pages
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33942&lcdStatus=all&sortBy=title&stateRegion=all&ver=47
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=90&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=283&proposed=Y

### 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-r70

### Example pages
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33942&lcdStatus=all&sortBy=title&stateRegion=all&ver=47
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=90&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=283&proposed=Y

---

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

**Bug ID:** `VS-7f87c74c`  
**Pattern ID:** `VS-91d2294a`  
**URL:** http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=297  
**XPath / selector:** `font`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `font-element`  
**Severity:** Moderate  
**Frequency:** 87 instances; 3 of 6702 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W33 (9 weeks)

### HTML snippet
```html
<font color="FF0000">- Transcatheter Edge-to-Edge Repair (TEER) for Mitral Valve Regurgitation</font>
```

### Description
Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 3 of 6702 scanned pages (87 instances).

### Steps to reproduce
1. Open http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=297.
2. Locate the element: font
3. Confirm the deprecated-html finding for rule font-element.

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

### Affected pages
- http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=297
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=380&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=283&proposed=Y

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

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

### Example pages
- http://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=297
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=380&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=283&proposed=Y

---

## First focusable element is link to main content (WCAG criterion undetermined)

**Bug ID:** `VS-6629c655`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://www.cms.gov/priorities/electronic-prior-authorization/overview  
**XPath / selector:** `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r87` ([reference](https://alfa.siteimprove.com/rules/sia-r87))  
**Severity:** Moderate  
**Frequency:** 2 instances; 2 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (6 weeks)

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

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

### Affected pages
- https://www.cms.gov/priorities/electronic-prior-authorization/overview
- https://cms.gov/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
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87

### Example pages
- https://www.cms.gov/priorities/electronic-prior-authorization/overview
- https://cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/medicare-geographic-variation

---

## aria attribute is permitted for element role (WCAG criterion undetermined)

**Bug ID:** `VS-c0deeae5`  
**Pattern ID:** `VS-e05344b9`  
**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"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r18` ([reference](https://alfa.siteimprove.com/rules/sia-r18))  
**Severity:** Moderate  
**Frequency:** 3 instances; 1 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (6 weeks)

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

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

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

---

## Keyboard trap does not exist (WCAG criterion undetermined)

**Bug ID:** `VS-8e6b1162`  
**Pattern ID:** `VS-4c341c77`  
**URL:** https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=258  
**XPath / selector:** `<p>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r85` ([reference](https://alfa.siteimprove.com/rules/sia-r85))  
**Severity:** Moderate  
**Frequency:** 3 instances; 1 of 6702 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W33 (9 weeks)

### Description
Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 1 of 6702 scanned pages (3 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=258.
2. Locate the element: <p>
3. Confirm the Siteimprove Alfa finding for rule sia-r85.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=258

### 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-r85

---

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

**Bug ID:** `VS-2ebb5f66`  
**Pattern ID:** `VS-20060f39`  
**URL:** http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33942&lcdStatus=all&sortBy=title&stateRegion=all&ver=47  
**XPath / selector:** `center`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `center-element`  
**Severity:** Moderate  
**Frequency:** 4 instances; 1 of 6702 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W33 (3 weeks)

### HTML snippet
```html
<center><strong> GENERAL THERAPY GUIDELINES</strong></center>
```

### Description
Obsolete <center> element (use CSS). Detected by deprecated-html rule center-element on 1 of 6702 scanned pages (4 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33942&lcdStatus=all&sortBy=title&stateRegion=all&ver=47.
2. Locate the element: center
3. Confirm the deprecated-html finding for rule center-element.

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

### Affected pages
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33942&lcdStatus=all&sortBy=title&stateRegion=all&ver=47

### 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.