www.cms.gov: Accessibility — week 2026-W34

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

Training priorities

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

SC	Criterion	Pages	Rules	Notes
1.4.8	WCAG 1.4.8	1296	4	Component inconsistency
2.5.5	WCAG 2.5.5	832	1
1.3.1	Info and Relationships (semantic structure)	578	7
1.4.1	Use of Color	536	2
2.5.3	WCAG 2.5.3	426	1

Next 10 actions

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

Design-system alignment (cms-ds / default). ds-c-pagination: 100% of sampled rule findings · ds-c-spinner: 100% of sampled rule findings

Top 10 clustered component fixes for this week.
Cluster	Severity	Pages	Who it affects	How to fix	Evidence	Decision
Form field label is visible · unattributed component Fix one place, resolve ~793 finding(s) on 793 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	793	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~276 finding(s) on 276 page(s). XPath / selector: `text: "Feedback"`	Moderate	276	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
<html> element must have a lang attribute · unattributed component Fix one place, resolve ~145 finding(s) on 145 page(s). XPath / selector: `html` `<html>`	Serious	145	Without vision, Limited cognitive, language, or learning ability	Add a lang attribute to <html> (e.g. lang="en").	pages (CSV)	Decision Assigned to Notes
Document should have one main landmark · unattributed component Fix one place, resolve ~145 finding(s) on 145 page(s). XPath / selector: `html` `<html>`	Moderate	145	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Images must have alternative text · unattributed component Fix one place, resolve ~127 finding(s) on 127 page(s). XPath / selector: `img[src$="cms-site-logo.png"]` `<img src="cms-site-logo.png">`	Critical	127	Without vision, Limited vision, Limited cognitive, language, or learning ability	Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.	pages (CSV)	Decision Assigned to Notes
Element has required aria-owns · unattributed component Fix one place, resolve ~92 finding(s) on 54 page(s). XPath / selector: `<th scope="col">`	Moderate	54	Without vision, Limited vision, Limited cognitive, language, or learning ability	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46	pages (CSV)	Decision Assigned to Notes
Text has enhanced contrast · unattributed component Fix one place, resolve ~425 finding(s) on 425 page(s). XPath / selector: `text: "Here's how you know"`	Moderate	425	Requires manual testing.	Increase text contrast to meet WCAG AAA (7:1).	pages (CSV)	Decision Assigned to Notes
Text has enhanced contrast · unattributed component Fix one place, resolve ~425 finding(s) on 425 page(s). XPath / selector: `text: "Centers for Medicare & Medicaid Services"`	Moderate	425	Requires manual testing.	Increase text contrast to meet WCAG AAA (7:1).	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~425 finding(s) on 425 page(s). XPath / selector: `<a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">`	Moderate	425	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~373 finding(s) on 373 page(s). XPath / selector: `<a href="#" data-bs-toggle="collapse" id="aCollapseNavigation" aria-label="Collapse Document Navigation">`	Moderate	373	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes

Bug reports

11 issue type(s) are shown by default out of 33 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 2 critical, 6 serious, 24 moderate, 1 minor. By WCAG category: 10 WCAG 2.0 A, 2 WCAG 2.0 AA, 1 WCAG 2.2 AA, 3 WCAG 2.x AAA, 8 Best Practice, 9 Undetermined. Ordered by severity, key-page impact, WCAG level, and prevalence. Following accessibility bug-reporting best practices. Download: Markdown · JSON (full archive) · JSON (AI diagnostic) · CSV (all findings) · Priority pages CSV · Priority pages JSON.

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

Default view shows 11 prioritized issue type(s); 22 more are available if you switch to "Show everything".

Findings needing review

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

Serious axe html-has-lang WCAG 2.0 A <html> element must have a lang attribute (WCAG 3.1.1) 145/5906 pages · 145 instances Likely template

Bug ID: VS-27193a5a
Pattern ID: VS-c126b6a6
Combined ID: VS-27193a5a (pattern VS-c126b6a6) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: axe-core — <html> element must have a lang attribute [html-has-lang]
Example URL: http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

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

<html>

Description

<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 145 of 5906 scanned pages (145 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html.
Locate the element: html
Confirm the axe-core finding for rule html-has-lang against WCAG 3.1.1 Language of Page.

Impact

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

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

Affected pages

…and more — all 145 pages (CSV).

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Critical axe image-alt WCAG 2.0 A Images must have alternative text (WCAG 1.1.1) 128/5906 pages · 128 instances Likely template

Bug ID: VS-fdf53f11
Pattern ID: VS-9074b4dd
Combined ID: VS-fdf53f11 (pattern VS-9074b4dd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: axe-core — Images must have alternative text [image-alt]
Example URL: http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html
XPath / selector: img[src$="cms-site-logo.png"]
History: first seen 2026-W24, last seen 2026-W34 (10 wk)

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

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

Description

Images must have alternative text. Detected by axe-core rule image-alt on 128 of 5906 scanned pages (128 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html.
Locate the element: img[src$="cms-site-logo.png"]
Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

Impact

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

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

Affected pages

…and more — all 128 pages (CSV).

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Critical axe label WCAG 2.0 A Form elements must have labels (WCAG 4.1.2) 18/5906 pages · 18 instances Likely template

Bug ID: VS-118d5bd0
Pattern ID: VS-fafffee0
Combined ID: VS-118d5bd0 (pattern VS-fafffee0) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Form elements must have labels [label]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1156.html
XPath / selector: #q
History: first seen 2026-W26, last seen 2026-W34 (9 wk)

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

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

Description

Form elements must have labels. Detected by axe-core rule label on 18 of 5906 scanned pages (18 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1156.html.
Locate the element: #q
Confirm the axe-core finding for rule label against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

Testing environment

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

Suggested fix

How to fix: Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.

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

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

Triage status Notes

Serious axe link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 2/5906 pages · 3 instances

Bug ID: VS-531530b7
Pattern ID: VS-e9fe47ac
Combined ID: VS-531530b7 (pattern VS-e9fe47ac) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: axe-core — Links must have discernible text [link-name]
Example URL: https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=NCA&ncaid=321&proposed=Y&sortBy=status&status=Open+for+Public+Comment
XPath / selector: li:nth-child(5) > a[href="#4"]
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

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

<a href="#4">	</a>

Description

Links must have discernible text. Detected by axe-core rule link-name on 3 of 5906 scanned pages (4 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=NCA&ncaid=321&proposed=Y&sortBy=status&status=Open+for+Public+Comment.
Locate the element: li:nth-child(5) > a[href="#4"]
Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Serious axe valid-lang WCAG 2.0 AA lang attribute must have a valid value (WCAG 3.1.2) 1/5906 pages · 6 instances

Bug ID: VS-c6c09410
Pattern ID: VS-dd1c019f
Combined ID: VS-c6c09410 (pattern VS-dd1c019f) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 3.1.2 Language of Parts (Level AA, WCAG 2.0)
Rule: axe-core — lang attribute must have a valid value [valid-lang]
Example URL: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33609&lcdStatus=all&sortBy=title&stateRegion=all&ver=14
XPath / selector: li:nth-child(1) > span[lang="X-NONE"]
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

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

<span lang="X-NONE">

Description

lang attribute must have a valid value. Detected by axe-core rule valid-lang on 3 of 5906 scanned pages (19 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33609&lcdStatus=all&sortBy=title&stateRegion=all&ver=14.
Locate the element: li:nth-child(1) > span[lang="X-NONE"]
Confirm the axe-core finding for rule valid-lang against WCAG 3.1.2 Language of Parts.

Impact

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

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

Affected pages

/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings

Testing environment

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

Suggested fix

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

Triage status Notes

Serious axe aria-hidden-focus WCAG 2.0 A ARIA hidden element must not be focusable or contain focusable elements (WCAG 4.1.2) 1/5906 pages · 5 instances Likely content

Bug ID: VS-7836015d
Pattern ID: VS-45146742
Combined ID: VS-7836015d (pattern VS-45146742) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — ARIA hidden element must not be focusable or contain focusable elements [aria-hidden-focus]
Example URL: http://www.cms.gov/newsroom/fact-sheets/market-saturation-utilization-data-tool-0
XPath / selector: #link-list-block-cms-evo-cmshhswebsitescmsglobalfooter-menu
History: first seen 2026-W34, last seen 2026-W34 (1 wk)

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

<div id="link-list-block-cms-evo-cmshhswebsitescmsglobalfooter-menu" aria-hidden="true" class="cms--link-list__links">

Description

ARIA hidden element must not be focusable or contain focusable elements. Detected by axe-core rule aria-hidden-focus on 1 of 5906 scanned pages (5 instances).

Steps to reproduce

Open http://www.cms.gov/newsroom/fact-sheets/market-saturation-utilization-data-tool-0.
Locate the element: #link-list-block-cms-evo-cmshhswebsitescmsglobalfooter-menu
Confirm the axe-core finding for rule aria-hidden-focus 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

/newsroom/fact-sheets/market-saturation-utilization-data-tool-0

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 put focusable elements inside aria-hidden="true"; they become a keyboard trap for screen-reader users.

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

Triage status Notes

Serious axe td-headers-attr WCAG 2.0 A Table cell headers attributes must refer to other <th> elements in the same tabl (WCAG 1.3.1) 1/5906 pages · 1 instances Likely content

Bug ID: VS-21eb1a2a
Pattern ID: VS-07ba3b17
Combined ID: VS-21eb1a2a (pattern VS-07ba3b17) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — Table cell headers attributes must refer to other <th> elements in the same tabl [td-headers-attr]
Example URL: https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_release_date&page=9&sort=desc
XPath / selector: .MsoTableGrid
History: first seen 2026-W25, last seen 2026-W34 (10 wk)

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

<table class="MsoTableGrid">

Description

Table cell headers attributes must refer to other <th> elements in the same tabl. Detected by axe-core rule td-headers-attr on 1 of 5906 scanned pages (1 instances).

Steps to reproduce

Open https://cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_release_date&page=9&sort=desc.
Locate the element: .MsoTableGrid
Confirm the axe-core finding for rule td-headers-attr against WCAG 1.3.1 Info and Relationships.

Impact

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

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

Affected pages

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

Testing environment

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

Suggested fix

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

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

Triage status Notes

Serious axe accesskeys Best Practice accesskey attribute value should be unique (WCAG criterion undetermined) 39/5906 pages · 114 instances Likely template

Bug ID: VS-3b5b9dbc
Pattern ID: VS-bd13f00a
Combined ID: VS-3b5b9dbc (pattern VS-bd13f00a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — accesskey attribute value should be unique [accesskeys]
Example URL: https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0175.html
XPath / selector: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0174.html"]
History: first seen 2026-W25, last seen 2026-W34 (8 wk)

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

<a accesskey="p" id="prev_page" href="P0174.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 5906 scanned pages (114 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0175.html.
Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0174.html"]
Confirm the axe-core finding for rule accesskeys.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 39 pages (CSV).

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r4 WCAG 2.0 A Document has a valid lang attribute (WCAG 3.1.1) 38/5906 pages · 38 instances Likely template

Bug ID: VS-7bd09a4c
Pattern ID: VS-7a0e5645
Combined ID: VS-7bd09a4c (pattern VS-7a0e5645) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Document has a valid lang attribute [sia-r4]
Example URL: http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html
XPath / selector: <html>
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 38 of 5906 scanned pages (38 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html.
Locate the element: <html>
Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page.

Impact

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

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

Affected pages

…and more — all 38 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r64 WCAG 2.0 A Element has required owned roles (WCAG 1.3.1) 35/5906 pages · 35 instances Likely template

Bug ID: VS-f50347d0
Pattern ID: VS-3c632d31
Combined ID: VS-f50347d0 (pattern VS-3c632d31) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Element has required owned roles [sia-r64]
Example URL: http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 35 of 5906 scanned pages (35 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html.
Locate the element: <h1>
Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

Impact

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

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

Affected pages

…and more — all 35 pages (CSV).

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 34/5906 pages · 34 instances Likely template

Bug ID: VS-8399a15c
Pattern ID: VS-a24eaa8c
Combined ID: VS-8399a15c (pattern VS-a24eaa8c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Image has accessible name [sia-r2]
Example URL: http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html
XPath / selector: <img src="cms-site-logo.png">
History: first seen 2026-W24, last seen 2026-W34 (10 wk)

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 34 of 5906 scanned pages (34 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html.
Locate the element: <img src="cms-site-logo.png">
Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

Impact

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

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

Affected pages

…and more — all 34 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 276/5906 pages · 276 instances Likely template

Bug ID: VS-a865c57c
Pattern ID: VS-c18be945
Combined ID: VS-a865c57c (pattern VS-c18be945) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Scrolling content can be accessed by keyboard [sia-r57]
Example URL: https://cms.gov/regulations-and-guidance/guidance/transmittals/2018-transmittals-items/r204ncd
XPath / selector: text: "Feedback"
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 276 of 5906 scanned pages (276 instances).

Steps to reproduce

Open https://cms.gov/regulations-and-guidance/guidance/transmittals/2018-transmittals-items/r204ncd.
Locate the element: text: "Feedback"
Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 276 pages (CSV).

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 145/5906 pages · 2740 instances Likely template

Bug ID: VS-bd52dbd4
Pattern ID: VS-f18df681
Combined ID: VS-bd52dbd4 (pattern VS-f18df681) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — All page content should be contained by landmarks [region]
Example URL: http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html
XPath / selector: .arrows > tbody > tr:nth-child(1)
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

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

<tr>
		<td><img src="cms-site-logo.png"></td>
		<td style="text-align:center;"><h1>ICD-10-CM/PCS MS-DRG v37.2 Definitions Manual</h1><h1></h1></td>
		<td></td>
		<td></td>
		<td></td>
	</tr>

Description

All page content should be contained by landmarks. Detected by axe-core rule region on 145 of 5906 scanned pages (2740 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html.
Locate the element: .arrows > tbody > tr:nth-child(1)
Confirm the axe-core finding for rule region.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 145 pages (CSV).

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Moderate axe landmark-one-main Best Practice Document should have one main landmark (WCAG criterion undetermined) 145/5906 pages · 145 instances Likely template

Bug ID: VS-13f99aff
Pattern ID: VS-d5d82446
Combined ID: VS-13f99aff (pattern VS-d5d82446) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should have one main landmark [landmark-one-main]
Example URL: http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

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

<html>

Description

Document should have one main landmark. Detected by axe-core rule landmark-one-main on 145 of 5906 scanned pages (145 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html.
Locate the element: html
Confirm the axe-core finding for rule landmark-one-main.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 145 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Minor axe empty-heading Best Practice Headings should not be empty (WCAG criterion undetermined) 132/5906 pages · 132 instances Likely template

Bug ID: VS-15ab7030
Pattern ID: VS-0066c67d
Combined ID: VS-15ab7030 (pattern VS-0066c67d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Headings should not be empty [empty-heading]
Example URL: http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html
XPath / selector: h1:nth-child(2)
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

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

<h1></h1>

Description

Headings should not be empty. Detected by axe-core rule empty-heading on 132 of 5906 scanned pages (132 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html.
Locate the element: h1:nth-child(2)
Confirm the axe-core finding for rule empty-heading.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 132 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 30/5906 pages · 30 instances Likely template

Bug ID: VS-0cbfd628
Pattern ID: VS-fa44f293
Combined ID: VS-0cbfd628 (pattern VS-fa44f293) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Page should contain a level-one heading [page-has-heading-one]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1156.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

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

<html>

Description

Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 30 of 5906 scanned pages (30 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1156.html.
Locate the element: html
Confirm the axe-core finding for rule page-has-heading-one.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 30 pages (CSV).

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 10/5906 pages · 10424 instances Likely template

Bug ID: VS-d732e79c
Pattern ID: VS-cb53cc4d
Combined ID: VS-d732e79c (pattern VS-cb53cc4d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 2.5.5 Target Size (Enhanced) (Level AAA, WCAG 2.1)
Rule: Siteimprove Alfa — Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]
Example URL: http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33751&lcdStatus=all&sortBy=title&ver=37
XPath / selector: <a href="#h3LcdGuidanceHeader" data-href="h3LcdGuidanceHeader" class="nav-link toc-link no-link log-click" title="Jump to Coverage Guidance">
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 832 of 5906 scanned pages (26061 instances).

Steps to reproduce

Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33751&lcdStatus=all&sortBy=title&ver=37.
Locate the element: <a href="#h3LcdGuidanceHeader" data-href="h3LcdGuidanceHeader" class="nav-link toc-link no-link log-click" title="Jump to Coverage Guidance">
Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 10/5906 pages · 4518 instances Likely template

Bug ID: VS-2e78144b
Pattern ID: VS-2208081b
Combined ID: VS-2e78144b (pattern VS-2208081b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has minimum contrast ratio of 4.5:1 [sia-r73]
Example URL: http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33751&lcdStatus=all&sortBy=title&ver=37
XPath / selector: <p class="usa-banner__header-text">
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 824 of 5906 scanned pages (11295 instances).

Steps to reproduce

Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33751&lcdStatus=all&sortBy=title&ver=37.
Locate the element: <p class="usa-banner__header-text">
Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 10/5906 pages · 317 instances Likely template

Bug ID: VS-ba9df155
Pattern ID: VS-7118fead
Combined ID: VS-ba9df155 (pattern VS-7118fead) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field label is visible [sia-r61]
Example URL: http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33751&lcdStatus=all&sortBy=title&ver=37
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 793 of 5906 scanned pages (793 instances).

Steps to reproduce

Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33751&lcdStatus=all&sortBy=title&ver=37.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r61.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 9/5906 pages · 351 instances Likely template

Bug ID: VS-44d6bda5
Pattern ID: VS-04a9d28c
Combined ID: VS-44d6bda5 (pattern VS-04a9d28c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: deprecated-html — Presentational attribute (use CSS) [presentational-attr]
Example URL: http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html
XPath / selector: img
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

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

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

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 33 of 5906 scanned pages (974 instances).

Steps to reproduce

Open http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html.
Locate the element: img
Confirm the deprecated-html finding for rule presentational-attr.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

Not captured by automated scan — requires manual testing.

Triage status Notes

Moderate alfa sia-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 7/5906 pages · 111 instances Likely template

Bug ID: VS-6beff459
Pattern ID: VS-179ad9b3
Combined ID: VS-6beff459 (pattern VS-179ad9b3) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.2 AA
Obligation: required
Handling: review
WCAG SC: 2.5.8 Target Size (Minimum) (Level AA, WCAG 2.2)
Rule: Siteimprove Alfa — Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]
Example URL: http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html
XPath / selector: <a href="http://www.hhs.gov">
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 156 of 5906 scanned pages (396 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html.
Locate the element: <a href="http://www.hhs.gov">
Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

Impact

Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%).

Limited manipulation/strength — 13.0% of population
Limited reach — 2.0% of population
Limited vision — 2.4% of population

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 7/5906 pages · 81 instances Likely template

Bug ID: VS-652a805b
Pattern ID: VS-2cd767ca
Combined ID: VS-652a805b (pattern VS-2cd767ca) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Table header has scope [sia-r78]
Example URL: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53049&ver=99
XPath / selector: <h4>
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 200 of 5906 scanned pages (289 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53049&ver=99.
Locate the element: <h4>
Confirm the Siteimprove Alfa finding for rule sia-r78.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r68 WCAG 2.0 A Presentational children of an element are not focusable (WCAG 1.3.1) 4/5906 pages · 55 instances Likely template

Bug ID: VS-d4351dce
Pattern ID: VS-d6097011
Combined ID: VS-d4351dce (pattern VS-d6097011) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Presentational children of an element are not focusable [sia-r68]
Example URL: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33576&lcdStatus=all&sortBy=title&ver=24
XPath / selector: <ul>
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 119 of 5906 scanned pages (342 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33576&lcdStatus=all&sortBy=title&ver=24.
Locate the element: <ul>
Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r75 Undetermined Form field error is identified and described (WCAG criterion undetermined) 4/5906 pages · 8 instances

Bug ID: VS-5ff352f6
Pattern ID: VS-e43903a1
Combined ID: VS-5ff352f6 (pattern VS-e43903a1) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field error is identified and described [sia-r75]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0294.html
XPath / selector: <ul id="globar">
History: first seen 2026-W26, last seen 2026-W34 (9 wk)

Description

Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 4 of 5906 scanned pages (8 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0294.html.
Locate the element: <ul id="globar">
Confirm the Siteimprove Alfa finding for rule sia-r75.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r75

Triage status Notes

Moderate alfa sia-r59 Undetermined Element with orientation is not locked (WCAG criterion undetermined) 4/5906 pages · 4 instances

Bug ID: VS-661c8ba8
Pattern ID: VS-7fbb8b20
Combined ID: VS-661c8ba8 (pattern VS-7fbb8b20) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Element with orientation is not locked [sia-r59]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0294.html
XPath / selector: {"type":"document","children":[{"type":"element","children":[{"type":"element","
History: first seen 2026-W26, last seen 2026-W34 (9 wk)

Description

Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 4 of 5906 scanned pages (4 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0294.html.
Locate the element: {"type":"document","children":[{"type":"element","children":[{"type":"element","
Confirm the Siteimprove Alfa finding for rule sia-r59.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r59

Triage status Notes

Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 3/5906 pages · 37 instances Likely template

Bug ID: VS-543974d1
Pattern ID: VS-d25f622d
Combined ID: VS-543974d1 (pattern VS-d25f622d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Heading levels should only increase by one [heading-order]
Example URL: http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=34537&lcdStatus=all&sortBy=title
XPath / selector: #navStickyHeader
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

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

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

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 299 of 5906 scanned pages (305 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=34537&lcdStatus=all&sortBy=title.
Locate the element: #navStickyHeader
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Moderate alfa sia-r18 Undetermined aria attribute is permitted for element role (WCAG criterion undetermined) 2/5906 pages · 7 instances Likely content

Bug ID: VS-33024341
Pattern ID: VS-e05344b9
Combined ID: VS-33024341 (pattern VS-e05344b9) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — aria attribute is permitted for element role [sia-r18]
Example URL: http://cms.gov/priorities/innovation/evaluation-research-reports
XPath / selector: @aria-invalid="false"
History: first seen 2026-W25, last seen 2026-W34 (7 wk)

Description

aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 2 of 5906 scanned pages (7 instances).

Steps to reproduce

Open http://cms.gov/priorities/innovation/evaluation-research-reports.
Locate the element: @aria-invalid="false"
Confirm the Siteimprove Alfa finding for rule sia-r18.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate axe landmark-banner-is-top-level Best Practice Banner landmark should not be contained in another landmark (WCAG criterion undetermined) 2/5906 pages · 2 instances Likely content

Bug ID: VS-cad2f204
Pattern ID: VS-30db094d
Combined ID: VS-cad2f204 (pattern VS-30db094d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]
Example URL: http://cms.gov/data-research/statistics-trends-reports/comprehensive-end-stage-renal-disease-esrd-care-cec-model-public-use-files
XPath / selector: .Header
History: first seen 2026-W24, last seen 2026-W34 (8 wk)

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

<header class="Header" style="position: sticky;">

Description

Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 2 of 5906 scanned pages (2 instances).

Steps to reproduce

Open http://cms.gov/data-research/statistics-trends-reports/comprehensive-end-stage-renal-disease-esrd-care-cec-model-public-use-files.
Locate the element: .Header
Confirm the axe-core finding for rule landmark-banner-is-top-level.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r53 Undetermined Headings are structured hierarchically (WCAG criterion undetermined) 1/5906 pages · 16 instances Likely template

Bug ID: VS-822a8be2
Pattern ID: VS-f054f4a4
Combined ID: VS-822a8be2 (pattern VS-f054f4a4) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Headings are structured hierarchically [sia-r53]
Example URL: http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33751&lcdStatus=all&sortBy=title&ver=37
XPath / selector: <h3 id="h3DocumentInformationHeader" class="document-view-section-header">
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 392 of 5906 scanned pages (392 instances).

Steps to reproduce

Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33751&lcdStatus=all&sortBy=title&ver=37.
Locate the element: <h3 id="h3DocumentInformationHeader" class="document-view-section-header">
Confirm the Siteimprove Alfa finding for rule sia-r53.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/medicare/regulations-guidance/advisory-committees/advisory-committee-air-ambulance-quality-patient-safety

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r80 WCAG 2.x AAA Scrollable element is keyboard accessible (WCAG 1.4.8) 1/5906 pages · 13 instances Likely template

Bug ID: VS-8abe1017
Pattern ID: VS-388b5438
Combined ID: VS-8abe1017 (pattern VS-388b5438) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Scrollable element is keyboard accessible [sia-r80]
Example URL: http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37761&lcdStatus=all&sortBy=title&ver=22
XPath / selector: <p style="background: white; line-height: 14.4pt;">
History: first seen 2026-W25, last seen 2026-W34 (10 wk)

Description

Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 29 of 5906 scanned pages (319 instances).

Steps to reproduce

Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37761&lcdStatus=all&sortBy=title&ver=22.
Locate the element: <p style="background: white; line-height: 14.4pt;">
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

/cms20033-reconsideration-request-form

Testing environment

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

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r80

Triage status Notes

Moderate alfa sia-r69 WCAG 2.0 AA Text has sufficient color contrast (Enhanced) (WCAG 1.4.3) 1/5906 pages · 7 instances

Bug ID: VS-9bfeb24f
Pattern ID: VS-f7e99f4b
Combined ID: VS-9bfeb24f (pattern VS-f7e99f4b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.3 Contrast (Minimum) (Level AA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has sufficient color contrast (Enhanced) [sia-r69]
Example URL: https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36665&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
XPath / selector: text: "Clinicopathologic Findings"
History: first seen 2026-W24, last seen 2026-W34 (11 wk)

Description

Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 7 of 5906 scanned pages (48 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36665&lcdStatus=all&sortBy=title&stateRegion=all&ver=19.
Locate the element: text: "Clinicopathologic Findings"
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

/data-research/statistics-trends-reports/comprehensive-end-stage-renal-disease-esrd-care-cec-model-public-use-files

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r87 Undetermined First focusable element is link to main content (WCAG criterion undetermined) 1/5906 pages · 1 instances Likely content

Bug ID: VS-516b3c00
Pattern ID: VS-aa242c2d
Combined ID: VS-516b3c00 (pattern VS-aa242c2d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — First focusable element is link to main content [sia-r87]
Example URL: https://www.cms.gov/data-research/statistics-trends-reports/comprehensive-end-stage-renal-disease-esrd-care-cec-model-public-use-files
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W25, last seen 2026-W34 (7 wk)

Description

First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 1 of 5906 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/data-research/statistics-trends-reports/comprehensive-end-stage-renal-disease-esrd-care-cec-model-public-use-files.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r87.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/data-research/statistics-trends-reports/comprehensive-end-stage-renal-disease-esrd-care-cec-model-public-use-files

Testing environment

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

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87

Triage status Notes

Moderate axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 1/5906 pages · 1 instances Likely content

Bug ID: VS-b06f71ce
Pattern ID: VS-8806389c
Combined ID: VS-b06f71ce (pattern VS-8806389c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Landmarks should have a unique role or role/label/title (i.e. accessible name) c [landmark-unique]
Example URL: http://cms.gov/priorities/innovation/evaluation-research-reports
XPath / selector: nav[aria-labelledby="pagination-heading--9"]
History: first seen 2026-W25, last seen 2026-W34 (10 wk)

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

<nav class="ds-c-pagination" aria-labelledby="pagination-heading--9">

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 5906 scanned pages (1 instances).

Steps to reproduce

Open http://cms.gov/priorities/innovation/evaluation-research-reports.
Locate the element: nav[aria-labelledby="pagination-heading--9"]
Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/priorities/innovation/evaluation-research-reports

Testing environment

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

Suggested fix

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

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

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (23 rule type(s))

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

axe-core rules failing in 2026-W34, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Links must be distinguishable without relying on color [link-in-text-block]	serious	533	1304	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 533 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	355	1622	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 355 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	299	305	/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx /medicare-coverage-database/reports/local-coverage-mac-contacts-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx	all 299 pages (CSV)
All page content should be contained by landmarks [region]	moderate	145	2740	/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0175.html /icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html	all 145 pages (CSV)
<html> element must have a lang attribute [html-has-lang]	serious	145	145	/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0175.html /icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html	all 145 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	145	145	/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0175.html /icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html	all 145 pages (CSV)
Headings should not be empty [empty-heading]	minor	132	132	/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0175.html /icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html	all 132 pages (CSV)
Images must have alternative text [image-alt]	critical	128	128	/icd10m/version372-fullcode-cms/fullcode_cms/P0106.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0175.html /icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html	all 128 pages (CSV)
accesskey attribute value should be unique [accesskeys]	serious	39	114	/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0175.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0594.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0201.html	all 39 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	31	423	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 31 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	30	30	/icd10m/version33-fullcode-cms/fullcode_cms/P1156.html /medicaid-chip/community-engagement-support/eligibility-made-easy /icd10m/version33-fullcode-cms/fullcode_cms/P0578.html	all 30 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	27	814	/medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/details/medcac-meeting-details.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 27 pages (CSV)
Form elements must have labels [label]	critical	18	18	/icd10m/version33-fullcode-cms/fullcode_cms/P1156.html /icd10m/version33-fullcode-cms/fullcode_cms/P0578.html /icd10m/version33-fullcode-cms/fullcode_cms/P0499.html	all 18 pages (CSV)
<li> elements must be contained in a <ul> or <ol> [listitem]	serious	9	65	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/details/nca-proposed-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 9 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	8	12	/medicare-coverage-database/details/medcac-meeting-details.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 8 pages (CSV)
lang attribute must have a valid value [valid-lang]	serious	3	19	/medicare-coverage-database/view/lcd.aspx /data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings /medicare-coverage-database/view/lcd.aspx	all 3 pages (CSV)
Links must have discernible text [link-name]	serious	3	4	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare/medicaid-coordination/about/resources-integrated-care /medicare/quality/clinical-laboratory-improvement-amendments	all 3 pages (CSV)
Scrollable region must have keyboard access [scrollable-region-focusable]	serious	2	2	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 2 pages (CSV)
Banner landmark should not be contained in another landmark [landmark-banner-is-top-level]	moderate	2	2	/data-research/statistics-trends-reports/comprehensive-end-stage-renal-disease-esrd-care-cec-model-public-use-files /data-research/statistics-trends-reports/comprehensive-end-stage-renal-disease-esrd-care-cec-model-public-use-files	all 2 pages (CSV)
ARIA hidden element must not be focusable or contain focusable elements [aria-hidden-focus]	serious	1	5	/newsroom/fact-sheets/market-saturation-utilization-data-tool-0	all 1 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	1	1	/priorities/innovation/evaluation-research-reports	all 1 pages (CSV)
Table cell headers attributes must refer to other <th> elements in the same table [td-headers-attr]	serious	1	1	/medicare/regulations-guidance/transmittals/2022-transmittals	all 1 pages (CSV)
ARIA progressbar nodes must have an accessible name [aria-progressbar-name]	serious	1	1	/medicare-coverage-database/search-results.aspx	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (28 rule type(s))

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

Alfa rules failing in 2026-W34, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	832	26061	/medicare-coverage-database/view/lcd.aspx /regulations-and-guidance/guidance/transmittals/2018-transmittals-items/r204ncd /regulations-and-guidance/guidance/transmittals/2014-transmittals-items/r1414otn	all 832 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	824	11295	/medicare-coverage-database/view/lcd.aspx /regulations-and-guidance/guidance/transmittals/2018-transmittals-items/r204ncd /regulations-and-guidance/guidance/transmittals/2014-transmittals-items/r1414otn	all 824 pages (CSV)
Form field label is visible [sia-r61]	n/a	793	793	/medicare-coverage-database/view/lcd.aspx /regulations-and-guidance/guidance/transmittals/2018-transmittals-items/r204ncd /regulations-and-guidance/guidance/transmittals/2014-transmittals-items/r1414otn	all 793 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	427	27962	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 427 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	426	2642	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 426 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	426	1114	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 426 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	392	392	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 392 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	276	276	/regulations-and-guidance/guidance/transmittals/2018-transmittals-items/r204ncd /regulations-and-guidance/guidance/transmittals/2014-transmittals-items/r1414otn /marketplace/agents-brokers/shop-resources	all 276 pages (CSV)
Table header has scope [sia-r78]	n/a	200	289	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 200 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	156	396	/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html /medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/article.aspx	all 156 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	119	342	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-proposed-lcds-contractor-report.aspx	all 119 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	54	92	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 54 pages (CSV)
Document has a valid lang attribute [sia-r4]	n/a	38	38	/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0376.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0010.html	all 38 pages (CSV)
Element has required owned roles [sia-r64]	n/a	35	35	/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0376.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0010.html	all 35 pages (CSV)
Image has accessible name [sia-r2]	n/a	34	34	/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0012.html /icd10m/version39.0-fullcode-cms/fullcode_cms/P0376.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0010.html	all 34 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	29	319	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 29 pages (CSV)
iframe element is not empty [sia-r71]	n/a	16	406	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 16 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	7	48	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx	all 7 pages (CSV)
Table cell has header [sia-r77]	n/a	5	159	/medicare-coverage-database/details/medcac-meeting-details.aspx /medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/article.aspx	all 5 pages (CSV)
Form field error is identified and described [sia-r75]	n/a	4	8	/icd10m/version33-fullcode-cms/fullcode_cms/P0294.html /icd10m/version33-fullcode-cms/fullcode_cms/P0022.html /icd10m/version33-fullcode-cms/fullcode_cms/P1742.html	all 4 pages (CSV)
Duplicate role landmark is labeled [sia-r79]	n/a	4	4	/medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 4 pages (CSV)
Element with orientation is not locked [sia-r59]	n/a	4	4	/icd10m/version33-fullcode-cms/fullcode_cms/P0294.html /icd10m/version33-fullcode-cms/fullcode_cms/P0022.html /icd10m/version33-fullcode-cms/fullcode_cms/P1742.html	all 4 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	3	6	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 3 pages (CSV)
Element with lang attribute has correct language [sia-r7]	n/a	2	18	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 2 pages (CSV)
aria attribute is permitted for element role [sia-r18]	n/a	2	7	/priorities/innovation/evaluation-research-reports /data-research/statistics-trends-reports/comprehensive-end-stage-renal-disease-esrd-care-cec-model-public-use-files	all 2 pages (CSV)
No obsolete or deprecated elements are used [sia-r70]	n/a	2	2	/medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 2 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	1	3	/medicare-coverage-database/view/medcac-meeting.aspx	all 1 pages (CSV)
First focusable element is link to main content [sia-r87]	n/a	1	1	/data-research/statistics-trends-reports/comprehensive-end-stage-renal-disease-esrd-care-cec-model-public-use-files	all 1 pages (CSV)

Unique accessibility issues (axe + Alfa consolidated)

axe and Alfa both implement W3C ACT rules, so the same issue is often caught by both. These are deduplicated by ACT rule and page, so a shared finding counts once (7170 raw engine findings → 7061 unique).

Unique issues (rule × page): 7061
Caught by both engines: 109 highest confidence
axe only: 1949
Alfa only: 5003

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

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

Rules flagged by both axe-core and Alfa in 2026-W34, by pages affected.
Issue	Pages	Rule references
<html> element must have a lang attribute	145	axe html-has-lang · Alfa sia-r4 · ACT b5c3f8
Headings should not be empty	132	axe empty-heading · Alfa sia-r64 · ACT ffd0e9
Images must have alternative text	128	axe image-alt · Alfa sia-r2 · ACT 23a2a8
lang attribute must have a valid value	3	axe valid-lang · Alfa sia-r7 · ACT de46e4