# Accessibility bug reports — www.cms.gov, week 2026-W37

55 issue type(s) from 4636 pages scanned. Generated 2026-09-13 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-2d06859a`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html  
**XPath / selector:** `<a href="http://www.hhs.gov">`  
**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:** 664 instances; 154 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 154 of 4636 scanned pages (664 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html.
2. Locate the element: <a href="http://www.hhs.gov">
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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35000&ver=156
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56825&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56758&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55224&articleStatus=all&bc=3&sortBy=title&ver=37
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58095&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=16
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37475&ver=17
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=39
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54610&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53008&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=56
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54543&articleStatus=all&bc=3&sortBy=title&ver=14
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58237&ver=9
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59513&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=3
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0111.html
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58456&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0036.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57224&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1898.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1710.html

…and more — 154 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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35000&ver=156

---

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

**Bug ID:** `VS-dab47b31`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all  
**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:** 781 instances; 299 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 299 of 4636 scanned pages (781 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33996&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33906&lcdStatus=all&sortBy=title&ver=75
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35000&ver=156
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56825&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56758&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39023&lcdStatus=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54991&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39594&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55224&articleStatus=all&bc=3&sortBy=title&ver=37
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33944&lcdStatus=all&sortBy=title&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58095&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=16
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56216&articleStatus=all&bc=3&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34209&lcdStatus=all&sortBy=title&ver=36
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36706&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35163&lcdStatus=all&sortBy=title

…and more — 299 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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-031872fa`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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:** 235 instances; 235 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (13 weeks)

### HTML snippet
```html
<img src="cms-site-logo.png">
```

### Description
Images must have alternative text. Detected by axe-core rule image-alt on 235 of 4636 scanned pages (235 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0136.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0148.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0079.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0228.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0255.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2152.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0315.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0253.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0298.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0113.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0004.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0118.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0088.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0208.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0032.html

…and more — 235 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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html

---

## ARIA progressbar nodes must have an accessible name (WCAG 1.1.1)

**Bug ID:** `VS-d59efc27`  
**Pattern ID:** `VS-f7280372`  
**URL:** https://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=38841&sortBy=relevance  
**XPath / selector:** `#searchResults > tfoot > tr > .text-center[colspan="5"][data-exclude="true"] > .ds-c-spinner[aria-valuetext="Loading"][role="progressbar"]`  
**WCAG SC:** 1.1.1 — Non-text Content (Level A)  
**Rule:** axe-core — `aria-progressbar-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-progressbar-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 4636 pages affected
  
**History:** first seen 2026-W27, last seen 2026-W37 (5 weeks)

### HTML snippet
```html
<span class="ds-c-spinner" aria-valuetext="Loading" role="progressbar"></span>
```

### Description
ARIA progressbar nodes must have an accessible name. Detected by axe-core rule aria-progressbar-name on 1 of 4636 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=38841&sortBy=relevance.
2. Locate the element: #searchResults > tfoot > tr > .text-center[colspan="5"][data-exclude="true"] > .ds-c-spinner[aria-valuetext="Loading"][role="progressbar"]
3. Confirm the axe-core finding for rule aria-progressbar-name 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://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=38841&sortBy=relevance

### 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 progressbar an accessible name.

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

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-46f31f8a`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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:** 65 instances; 65 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (13 weeks)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 65 of 4636 scanned pages (65 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0111.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0036.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1898.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1710.html
- https://cms.gov/icd10m/version40-fullcode-cms/fullcode_cms/P0037.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0100.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0229.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0370.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0143.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0381.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0121.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0251.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0094.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0051.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P1020.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0019.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0031.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0356.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0035.html

…and more — 65 pages total ([download CSV](csv/alfa__sia-r2.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

### Example pages
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html

---

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

**Bug ID:** `VS-30f3877a`  
**Pattern ID:** `VS-a0bdbdf6`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36668&lcdStatus=all&sortBy=title&stateRegion=all&ver=45  
**XPath / selector:** `ol:nth-child(7)`  
**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:** 970 instances; 256 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<ol>
```

### Description
<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 256 of 4636 scanned pages (970 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36668&lcdStatus=all&sortBy=title&stateRegion=all&ver=45.
2. Locate the element: ol:nth-child(7)
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=8&contractorNumber=all&lcdid=36668&lcdStatus=all&sortBy=title&stateRegion=all&ver=45
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33960&lcdStatus=all&sortBy=title&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35093&lcdStatus=all&sortBy=title&ver=114
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33906&lcdStatus=all&sortBy=title&ver=75
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57364&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=14
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38968&lcdStatus=all&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56758&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58993&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=16
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33944&lcdStatus=all&sortBy=title&ver=26
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37166&lcdStatus=all&sortBy=title&ver=22
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39027&ver=7
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?ncaid=215
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57049&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=12
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34859&lcdStatus=all&sortBy=title&ver=34
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?areaId=all&articleid=56680&bc=1&contractOption=all&docType=6%2C1&keyword=foot+care&keywordType=starts&sortBy=relevance&ver=44
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57526&ver=90
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37475&ver=17
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53066&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=95
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58052&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=35090&ver=95
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39812&lcdStatus=all&sortBy=title&stateRegion=all&ver=14
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35702&lcdStatus=all&sortBy=title&ver=26

…and more — 256 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=8&contractorNumber=all&lcdid=36668&lcdStatus=all&sortBy=title&stateRegion=all&ver=45
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33960&lcdStatus=all&sortBy=title&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4

---

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

**Bug ID:** `VS-70d4714d`  
**Pattern ID:** `VS-6175596b`  
**URL:** http://cms.gov/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?ncaid=4  
**XPath / selector:** `div > li:nth-child(1)`  
**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:** 63 instances; 8 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<li>Is there objective evidence to show that use of an air-fluidized bed improves/heals Stage 3 and/or Stage 4 pressure ulcers?</li>
```

### Description
<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 8 of 4636 scanned pages (63 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?ncaid=4.
2. Locate the element: div > li:nth-child(1)
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
- http://cms.gov/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?ncaid=4
- http://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=69&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=296
- http://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=79&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=292&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=309
- https://www.cms.gov/medicare-coverage-database/details/nca-tracking-sheet.aspx?fromdb=true&NCAId=109
- https://www.cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?bc=17&ncacaldoctype=all&ncaid=223&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:** <li> must be inside a <ul> or <ol>.

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

### Example pages
- http://cms.gov/medicare-coverage-database/view/ncacal-tracking-sheet.aspx?ncaid=4
- http://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=69&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=296

---

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

**Bug ID:** `VS-85bf0f09`  
**Pattern ID:** `VS-07ba3b17`  
**URL:** https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&sort=desc  
**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:** 1 instances; 1 of 4636 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W37 (13 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 1 of 4636 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&sort=desc.
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://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&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

---

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

**Bug ID:** `VS-796cd800`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all  
**XPath / selector:** `<tfoot>`  
**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:** 215 instances; 94 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 94 of 4636 scanned pages (215 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
2. Locate the element: <tfoot>
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/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33906&lcdStatus=all&sortBy=title&ver=75
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39594&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33944&lcdStatus=all&sortBy=title&ver=26
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36706&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35163&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=39284&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38664&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33580&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38551&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=33563&ver=27
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37632&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=316
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=61
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0251.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33558&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=231
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34314&lcdStatus=all&sortBy=title&ver=52
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=39121&lcdStatus=all&sortBy=title
- http://www.cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-state-report.aspx?contractorNumber=all&lcdid=35170&proposedStatus=all&sortBy=title&stateRegion=all

…and more — 94 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/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4

---

## Element has required owned roles (WCAG 1.3.1)

**Bug ID:** `VS-ff0ef49c`  
**Pattern ID:** `VS-3c632d31`  
**URL:** http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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:** 66 instances; 66 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 66 of 4636 scanned pages (66 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0111.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0036.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1898.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1710.html
- https://cms.gov/icd10m/version40-fullcode-cms/fullcode_cms/P0037.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0100.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0229.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0370.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0143.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0381.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0121.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0251.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0094.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0051.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P1020.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0019.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0031.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0356.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0035.html

…and more — 66 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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html

---

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

**Bug ID:** `VS-28ee4c83`  
**Pattern ID:** `VS-4408605e`  
**URL:** http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&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:** 36 instances; 23 of 4636 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W37 (13 weeks)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 23 of 4636 scanned pages (36 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&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
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=39
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57224&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57149&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=16
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55058&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58250&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=14
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57954&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=66
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58216&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57778&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=54
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57957&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=52
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57329&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=17
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56633&articleStatus=all&bc=3&sortBy=title&ver=47
- http://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=79&sortBy=meetingdate&year=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56573&articleStatus=all&bc=3&sortBy=title&ver=21
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56615&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=23
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57067&ver=34
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55327&articleStatus=all&bc=3&sortBy=title&ver=36
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56515&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=21
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53064&ver=87
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56696&ver=43
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57162&articleStatus=all&bc=3&sortBy=title&ver=17
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56425&articleStatus=all&bc=3&sortBy=title&ver=16
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57914&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=9

### 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
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=39
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57224&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61

---

## Table cell has header (WCAG 1.3.1)

**Bug ID:** `VS-5a045fb4`  
**Pattern ID:** `VS-3f067795`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all  
**XPath / selector:** `<td valign="top">`  
**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:** 146 instances; 4 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 4 of 4636 scanned pages (146 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all.
2. Locate the element: <td valign="top">
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://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36868&lcdStatus=all&sortBy=title&ver=25
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=190&ncdver=2&sortBy=title
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=281&ncdver=8

### 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://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36868&lcdStatus=all&sortBy=title&ver=25
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=190&ncdver=2&sortBy=title

---

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

**Bug ID:** `VS-3cc8a967`  
**Pattern ID:** `VS-8ade3360`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36668&lcdStatus=all&sortBy=title&stateRegion=all&ver=45  
**XPath / selector:** `#lblProposedLcd > .system-link.log-click[target="_blank"]`  
**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:** 962 instances; 434 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<a href="https://localcoverage.cms.gov/mcd_archive/view/lcd.aspx?lcdInfo=39981:4" target="_blank" class="log-click system-link" data-page-action="Clicked the Source Proposed LCD link">DL36668</a>
```

### Description
Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 434 of 4636 scanned pages (962 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36668&lcdStatus=all&sortBy=title&stateRegion=all&ver=45.
2. Locate the element: #lblProposedLcd > .system-link.log-click[target="_blank"]
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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36668&lcdStatus=all&sortBy=title&stateRegion=all&ver=45
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38613&lcdStatus=all&sortBy=title&ver=16
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36797&lcdStatus=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33996&lcdStatus=all&sortBy=title&ver=33
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35093&lcdStatus=all&sortBy=title&ver=114
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55754&articleStatus=all&bc=3&sortBy=title&ver=16
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=40259&sortBy=relevance&ver=4
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38726&lcdStatus=all&sortBy=title&ver=15
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33822&lcdStatus=all&sortBy=title&ver=70
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33906&lcdStatus=all&sortBy=title&ver=75
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38613&lcdStatus=all&sortBy=title&ver=14
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35000&ver=156
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38968&lcdStatus=all&sortBy=title&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39023&lcdStatus=all&sortBy=title&ver=23
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35170&lcdStatus=all&sortBy=title&stateRegion=all&ver=49
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35000&lcdStatus=all&sortBy=title&ver=155
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36797&lcdStatus=all&sortBy=title&ver=20
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40052&lcdStatus=all&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37166&lcdStatus=all&sortBy=title&ver=22
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39027&ver=7
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35906&lcdStatus=all&sortBy=title&ver=24
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56793&articleStatus=all&bc=3&sortBy=title&ver=29

…and more — 434 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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36668&lcdStatus=all&sortBy=title&stateRegion=all&ver=45
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all

---

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

**Bug ID:** `VS-79a863b0`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56973&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=63  
**XPath / selector:** `<a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_33">`  
**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:** 13 instances; 7 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (13 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 7 of 4636 scanned pages (13 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56973&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=63.
2. Locate the element: <a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_33">
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://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56973&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=63
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37421&lcdStatus=all&sortBy=title&stateRegion=all&ver=24
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39481&lcdStatus=all&sortBy=title&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34540&lcdStatus=all&sortBy=title&stateRegion=all&ver=14
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36861&lcdStatus=all&sortBy=title&ver=15
- http://cms.gov/newsroom/press-contacts
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57597&ver=17

### 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

### Example pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56973&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=63
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37421&lcdStatus=all&sortBy=title&stateRegion=all&ver=24
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39481&lcdStatus=all&sortBy=title&ver=5

---

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

**Bug ID:** `VS-5cb0e969`  
**Pattern ID:** `VS-c613c153`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=206&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 4636 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W37 (9 weeks)

### HTML snippet
```html
<pre>
```

### Description
Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 2 of 4636 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=206&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=206&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=143&proposed=N&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=206&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=143&proposed=N&sortBy=status&status=all

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-d1e7fd9e`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** http://www.cms.gov/medicare/medicaid-coordination/about/dsnps  
**XPath / selector:** `a[data-entity-type="media"][data-entity-substitution="canonical"][data-once="linkMatch"]:nth-child(5)`  
**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:** 4 instances; 3 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<a data-entity-type="media" data-entity-uuid="c3d790c3-6ce7-4c9e-8624-03b88a3cb6ff" data-entity-substitution="canonical" href="/files/document/dsnpcoveragedecisionlettermemocy2024.pdf" data-once="link
```

### Description
Links must have discernible text. Detected by axe-core rule link-name on 3 of 4636 scanned pages (4 instances).

### Steps to reproduce
1. Open http://www.cms.gov/medicare/medicaid-coordination/about/dsnps.
2. Locate the element: a[data-entity-type="media"][data-entity-substitution="canonical"][data-once="linkMatch"]:nth-child(5)
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
- http://www.cms.gov/medicare/medicaid-coordination/about/dsnps
- http://www.cms.gov/newsroom/press-releases/trump-administration-finalizes-transformative-medicare-payment-changes-support-innovation-kidney
- 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
- http://www.cms.gov/medicare/medicaid-coordination/about/dsnps
- http://www.cms.gov/newsroom/press-releases/trump-administration-finalizes-transformative-medicare-payment-changes-support-innovation-kidney
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments

---

## Link has accessible name (WCAG 2.4.4)

**Bug ID:** `VS-66f1c424`  
**Pattern ID:** `VS-28ebd979`  
**URL:** http://www.cms.gov/medicare/medicaid-coordination/about/dsnps  
**XPath / selector:** `<a data-entity-type="media" data-entity-uuid="c3d790c3-6ce7-4c9e-8624-03b88a3cb6ff" data-entity-substitution="canonical" href="/files/document/dsnpcoveragedecisionlettermemocy2024.pdf">`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** Siteimprove Alfa — `sia-r11` ([reference](https://alfa.siteimprove.com/rules/sia-r11))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (12 weeks)

### Description
Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 4636 scanned pages (1 instances).

### Steps to reproduce
1. Open http://www.cms.gov/medicare/medicaid-coordination/about/dsnps.
2. Locate the element: <a data-entity-type="media" data-entity-uuid="c3d790c3-6ce7-4c9e-8624-03b88a3cb6ff" data-entity-substitution="canonical" href="/files/document/dsnpcoveragedecisionlettermemocy2024.pdf">
3. Confirm the Siteimprove Alfa finding for rule sia-r11 against WCAG 2.4.4 Link Purpose (In Context).

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

### Affected pages
- http://www.cms.gov/medicare/medicaid-coordination/about/dsnps

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

### Suggested fix
**How to fix:** Give the link an accessible name via text content or aria-label.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r11

---

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

**Bug ID:** `VS-4b84756b`  
**Pattern ID:** `VS-c126b6a6`  
**URL:** http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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:** 253 instances; 253 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<html>
```

### Description
<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 253 of 4636 scanned pages (253 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0136.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0148.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0079.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0228.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0255.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2152.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0315.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1876.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0253.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0298.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0113.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0004.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1313.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0118.html

…and more — 253 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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.html

---

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

**Bug ID:** `VS-5f58b846`  
**Pattern ID:** `VS-7a0e5645`  
**URL:** http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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:** 72 instances; 72 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 72 of 4636 scanned pages (72 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0111.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0036.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1898.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1710.html
- https://cms.gov/icd10m/version40-fullcode-cms/fullcode_cms/P0037.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0100.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0229.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0370.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0143.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0381.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0121.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0251.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0094.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0051.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0599.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P1020.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0019.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0031.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0356.html

…and more — 72 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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html

---

## Form elements must have labels (WCAG 4.1.2)

**Bug ID:** `VS-2311d8f5`  
**Pattern ID:** `VS-fafffee0`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.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:** 18 instances; 18 of 4636 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W37 (12 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 18 of 4636 scanned pages (18 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.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/P1203.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1876.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1313.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1722.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0599.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1022.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0598.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0447.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1189.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0132.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0652.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0452.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0510.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1573.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1550.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1164.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1176.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0098.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:** 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/P1203.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1876.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1313.html

---

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

**Bug ID:** `VS-6772d6cb`  
**Pattern ID:** `VS-be8d563e`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4  
**XPath / selector:** `font`  
**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:** 312 instances; 31 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<font color="FF0000">
```

### Description
Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 31 of 4636 scanned pages (312 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4.
2. Locate the element: font
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://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33393&lcdStatus=all&sortBy=title&ver=10
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0040.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33803&lcdStatus=all&sortBy=title&ver=47
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=306&proposed=Y
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0269.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37870&lcdStatus=all&sortBy=title&ver=19
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0304.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0012.html
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=275&proposed=N
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0031.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0197.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0014.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=36704&ver=20
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=296
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33370&ver=58
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52487&articleStatus=all&bc=3&sortBy=title&ver=25
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=40270&proposedStatus=all&sortBy=title&ver=19
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33370&proposedStatus=all&sortBy=title&stateRegion=all&ver=55
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=292&proposed=N&sortBy=status&status=all
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0011.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0001.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33393&lcdStatus=all&sortBy=title&stateRegion=all&ver=9

…and more — 31 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://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all

---

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

**Bug ID:** `VS-9c1c85b1`  
**Pattern ID:** `VS-f7e99f4b`  
**URL:** http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52  
**XPath / selector:** `text: "Situation"`  
**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:** 19 instances; 4 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 4 of 4636 scanned pages (19 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52.
2. Locate the element: text: "Situation"
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
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medical-bill-rights/help/submit-a-complaint/get-started
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33393&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=281&ncdver=8

### 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
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medical-bill-rights/help/submit-a-complaint/get-started
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33393&lcdStatus=all&sortBy=title&stateRegion=all&ver=9

---

## Zooming and scaling must not be disabled (WCAG 1.4.4)

**Bug ID:** `VS-892e36bd`  
**Pattern ID:** `VS-6c86a43a`  
**URL:** http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html  
**XPath / selector:** `meta[name="viewport"]`  
**WCAG SC:** 1.4.4 — Resize Text (Level AA)  
**Rule:** axe-core — `meta-viewport` ([reference](https://dequeuniversity.com/rules/axe/4.12/meta-viewport?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 2 instances; 2 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (7 weeks)

### HTML snippet
```html
<meta name="viewport" content="width=device-width,initial-scale=1,user-scalable=no,shrink-to-fit=no,minimal-ui">
```

### Description
Zooming and scaling must not be disabled. Detected by axe-core rule meta-viewport on 2 of 4636 scanned pages (2 instances).

### Steps to reproduce
1. Open http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html.
2. Locate the element: meta[name="viewport"]
3. Confirm the axe-core finding for rule meta-viewport against WCAG 1.4.4 Resize Text.

### Impact
Affects Limited vision (2.4%).
- **Limited vision** (2.4% of population)

### Affected pages
- http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html
- https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.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:** Don't disable zoom (user-scalable=no / maximum-scale=1); low-vision users need to zoom.

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

### Example pages
- http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html
- https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html

---

## Text is not too small to read (WCAG 1.4.4)

**Bug ID:** `VS-cb4f0373`  
**Pattern ID:** `VS-3a9437f7`  
**URL:** https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html  
**XPath / selector:** `<meta name="viewport" content="width=device-width,initial-scale=1,user-scalable=no,shrink-to-fit=no,minimal-ui">`  
**WCAG SC:** 1.4.4 — Resize Text (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r47` ([reference](https://alfa.siteimprove.com/rules/sia-r47))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 4636 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W37 (3 weeks)

### Description
Text is not too small to read. Detected by Siteimprove Alfa rule sia-r47 on 1 of 4636 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html.
2. Locate the element: <meta name="viewport" content="width=device-width,initial-scale=1,user-scalable=no,shrink-to-fit=no,minimal-ui">
3. Confirm the Siteimprove Alfa finding for rule sia-r47 against WCAG 1.4.4 Resize Text.

### Impact
Affects Limited vision (2.4%).
- **Limited vision** (2.4% of population)

### Affected pages
- https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.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-r47

---

## 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 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 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 4636 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

---

## Element with lang attribute has correct language (WCAG 3.1.2)

**Bug ID:** `VS-765760a0`  
**Pattern ID:** `VS-400f3a18`  
**URL:** https://www.cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings  
**XPath / selector:** `@lang="X-NONE"`  
**WCAG SC:** 3.1.2 — Language of Parts (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r7` ([reference](https://alfa.siteimprove.com/rules/sia-r7))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 4636 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W37 (6 weeks)

### Description
Element with lang attribute has correct language. Detected by Siteimprove Alfa rule sia-r7 on 1 of 4636 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: @lang="X-NONE"
3. Confirm the Siteimprove Alfa finding for rule sia-r7 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: 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-r7

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-1cfc1f38`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all  
**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:** 1792 instances; 300 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 300 of 4636 scanned pages (1792 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33996&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33906&lcdStatus=all&sortBy=title&ver=75
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35000&ver=156
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56825&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56758&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39023&lcdStatus=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54991&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39594&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55224&articleStatus=all&bc=3&sortBy=title&ver=37
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33944&lcdStatus=all&sortBy=title&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58095&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=16
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56216&articleStatus=all&bc=3&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34209&lcdStatus=all&sortBy=title&ver=36
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36706&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35163&lcdStatus=all&sortBy=title

…and more — 300 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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all

---

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

**Bug ID:** `VS-d0cb1fc7`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all  
**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:** 7976 instances; 672 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 672 of 4636 scanned pages (7976 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2023-transmittals?items_per_page=25&order=field_dyna_pe_number&page=1&sort=asc
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- 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/lcd.aspx?bc=6&lcdid=33996&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/newsroom/press-releases/trump-administration-releases-covid-19-checklists-tools-accelerate-relief-state-medicaid-chip
- https://cms.gov/about-cms/contact/directory/aging-center/1560246
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title
- https://cms.gov/medicare/payment/prospective-payment-systems/inpatient-rehabilitation/rules-related-files/cms-1781-f
- https://cms.gov/medicare/regulations-guidance/transmittals/2014-transmittals?items_per_page=25&order=field_dyna_release_date&page=4&sort=asc
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33906&lcdStatus=all&sortBy=title&ver=75
- https://www.cms.gov/about-cms/contact/directory/south-dakota-department-health/1562706
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10977otn
- https://www.cms.gov/about-cms/contact/directory/western-pacific-med-corp/1555071
- https://cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=7&sort=desc
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35000&ver=156
- http://www.cms.gov/newsroom/blog/cms-drug-spending-dashboards-inflation-reduction-act
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2015-transmittals-items/r3328cp
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56825&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- https://www.cms.gov/about-cms/contact/directory/american-addiction-treatment-center/1558831

…and more — 672 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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all

---

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

**Bug ID:** `VS-ddf31dcb`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all  
**XPath / selector:** `<p>`  
**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:** 21057 instances; 300 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 300 of 4636 scanned pages (21057 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
2. Locate the element: <p>
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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33996&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33906&lcdStatus=all&sortBy=title&ver=75
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35000&ver=156
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56825&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56758&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39023&lcdStatus=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54991&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39594&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55224&articleStatus=all&bc=3&sortBy=title&ver=37
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33944&lcdStatus=all&sortBy=title&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58095&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=16
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56216&articleStatus=all&bc=3&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34209&lcdStatus=all&sortBy=title&ver=36
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36706&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35163&lcdStatus=all&sortBy=title

…and more — 300 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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all

---

## Scrollable element is keyboard accessible (WCAG 1.4.8)

**Bug ID:** `VS-0a6193e4`  
**Pattern ID:** `VS-388b5438`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39023&lcdStatus=all&sortBy=title&ver=23  
**XPath / selector:** `<p style="line-height: 14.2pt;">`  
**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:** 400 instances; 32 of 4636 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W37 (13 weeks)

### Description
Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 32 of 4636 scanned pages (400 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39023&lcdStatus=all&sortBy=title&ver=23.
2. Locate the element: <p style="line-height: 14.2pt;">
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
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39023&lcdStatus=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37475&ver=17
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59217&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57149&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=16
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33821&lcdStatus=all&sortBy=title&ver=28
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39644&lcdStatus=all&sortBy=title&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52519&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=39
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57954&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=66
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59215&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=8
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37295&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58640&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=5
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59440&articleStatus=all&bc=3&sortBy=title&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59344&articleStatus=all&bc=3&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57957&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=52
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59215&articleStatus=all&bc=3&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39003&lcdStatus=all&sortBy=title&ver=15
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38613&lcdStatus=all&sortBy=title&ver=11
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52467&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=48
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58318&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=62
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58720&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=75
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56696&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38151&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37725&lcdStatus=all&sortBy=title&ver=44
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58726&articleStatus=all&bc=3&sortBy=title&ver=81

…and more — 32 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
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39023&lcdStatus=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37475&ver=17

---

## iframe element is not empty (WCAG 1.4.8)

**Bug ID:** `VS-b34202c7`  
**Pattern ID:** `VS-48291402`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&stateRegion=all&ver=9  
**XPath / selector:** `<p style="background: white; 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:** 227 instances; 19 of 4636 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W37 (13 weeks)

### Description
iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 19 of 4636 scanned pages (227 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&stateRegion=all&ver=9.
2. Locate the element: <p style="background: white; 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
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58456&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59217&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57149&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=16
- http://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/article.aspx?articleid=56344&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=2
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59215&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=8
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58456&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=41
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58640&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=5
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59440&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=33444&ver=42
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59344&articleStatus=all&bc=3&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59215&articleStatus=all&bc=3&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59714&articleStatus=all&bc=3&sortBy=title&ver=16
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39003&lcdStatus=all&sortBy=title&ver=15
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56696&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38151&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38997&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38051&lcdStatus=all&sortBy=title&stateRegion=all&ver=17

### 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
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58456&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59217&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4

---

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

**Bug ID:** `VS-4c909178`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all  
**XPath / selector:** `<a href="https://www.cms.gov" rel="noopener noreferrer" title="CMS.gov Centers for Medicare & Medicaid Services">`  
**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:** 23263 instances; 688 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 688 of 4636 scanned pages (23263 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
2. Locate the element: <a href="https://www.cms.gov" rel="noopener noreferrer" title="CMS.gov Centers for Medicare & Medicaid Services">
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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2023-transmittals?items_per_page=25&order=field_dyna_pe_number&page=1&sort=asc
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- 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/lcd.aspx?bc=6&lcdid=33996&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/newsroom/press-releases/trump-administration-releases-covid-19-checklists-tools-accelerate-relief-state-medicaid-chip
- https://cms.gov/about-cms/contact/directory/aging-center/1560246
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title
- https://cms.gov/medicare/payment/prospective-payment-systems/inpatient-rehabilitation/rules-related-files/cms-1781-f
- https://cms.gov/medicare/regulations-guidance/transmittals/2014-transmittals?items_per_page=25&order=field_dyna_release_date&page=4&sort=asc
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33906&lcdStatus=all&sortBy=title&ver=75
- https://www.cms.gov/about-cms/contact/directory/south-dakota-department-health/1562706
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10977otn
- https://www.cms.gov/about-cms/contact/directory/western-pacific-med-corp/1555071
- https://cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=7&sort=desc
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35000&ver=156
- http://www.cms.gov/newsroom/blog/cms-drug-spending-dashboards-inflation-reduction-act
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2015-transmittals-items/r3328cp
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56825&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- https://www.cms.gov/about-cms/contact/directory/american-addiction-treatment-center/1558831

…and more — 688 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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all

---

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

**Bug ID:** `VS-c620910b`  
**Pattern ID:** `VS-bd13f00a`  
**URL:** https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html  
**XPath / selector:** `td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0187.html"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `accesskeys` ([reference](https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 172 instances; 58 of 4636 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W37 (11 weeks)

### HTML snippet
```html
<a accesskey="p" id="prev_page" href="P0187.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 58 of 4636 scanned pages (172 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html.
2. Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0187.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/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0136.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0148.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2152.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0032.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0040.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0269.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P0130.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0353.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0720.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0486.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0143.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0556.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1863.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0178.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0304.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0104.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0012.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0718.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1749.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0031.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1198.html

…and more — 58 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/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0136.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0148.html

---

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

**Bug ID:** `VS-f282b7bf`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39810&lcdStatus=all&sortBy=title&stateRegion=all  
**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:** 295 instances; 287 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 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 287 of 4636 scanned pages (295 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39810&lcdStatus=all&sortBy=title&stateRegion=all.
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
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39810&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33671&lcdStatus=all&sortBy=title
- https://www.cms.gov/about-cms/what-we-do/nursing-homes/providers-cms-partners/technical-information
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=36159&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title
- https://www.cms.gov/apps/ama/license.asp?file=%2Ffiles%2Fzip%2Foctober-2024-asc-approved-hcpcs-code-and-payment-rates-updated-09%2F24%2F2024.zip
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=91&fromTracking=Y&proposed=N
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2FDownloads%2FApril_2007_ASP_NOC_File_031607.zip
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=239&proposed=Y
- http://www.cms.gov/medicare/medicaid-coordination/reduce-avoidable-hospitalizations/clinical-education-interventions
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=36393&lcdStatus=all&sortBy=title
- https://www.cms.gov/training-education/medicare-learning-network/newsletter/mln-connects-newsletter-may-6-2026
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39594&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=218&proposed=N
- https://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=34353&sortBy=relevance
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=252&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=40179&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=38571&lcdStatus=all&sortBy=title
- http://www.cms.gov/medicaid-chip/medicare-coordination/financial-alignment/beneficiary-counseling-ombdudsman
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36706&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37863&lcdStatus=all&sortBy=title
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2F2015-October-ASP-Pricing-File.zip
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35163&lcdStatus=all&sortBy=title

…and more — 287 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
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39810&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33671&lcdStatus=all&sortBy=title

---

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

**Bug ID:** `VS-ce7b1b8f`  
**Pattern ID:** `VS-d5d82446`  
**URL:** http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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:** 253 instances; 253 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<html>
```

### Description
Document should have one main landmark. Detected by axe-core rule landmark-one-main on 253 of 4636 scanned pages (253 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0136.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0148.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0079.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0228.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0255.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2152.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0315.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1876.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0253.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0298.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0113.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0004.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1313.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0118.html

…and more — 253 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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.html

---

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

**Bug ID:** `VS-8c392bc0`  
**Pattern ID:** `VS-f18df681`  
**URL:** http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html  
**XPath / selector:** `.arrows > tbody > tr:nth-child(1)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `region` ([reference](https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 4069 instances; 253 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<tr>
		<td><img src="cms-site-logo.png"></td>
		<td style="text-align:center;"><h1>ICD-10-CM/PCS MS-DRG v36.0 Definitions Manual</h1><h1></h1></td>
		<td></td>
		<td></td>
		<td></td>
	</tr>
```

### Description
All page content should be contained by landmarks. Detected by axe-core rule region on 253 of 4636 scanned pages (4069 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html.
2. Locate the element: .arrows > tbody > tr:nth-child(1)
3. Confirm the axe-core finding for rule region.

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

### Affected pages
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0136.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0148.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0079.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0228.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0255.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2152.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0315.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1876.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0253.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0298.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0113.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0004.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1313.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0118.html

…and more — 253 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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.html

---

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

**Bug ID:** `VS-a55634bd`  
**Pattern ID:** `VS-0ba8ce9d`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4  
**XPath / selector:** `td[width="25%"][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:** 1171 instances; 34 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<td width="25%" scope="row"> <a name="ac" id="ac"></a>Air Cleaners</td>
```

### Description
scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 34 of 4636 scanned pages (1171 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4.
2. Locate the element: td[width="25%"][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/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=239&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=218&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=252&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=165&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?bc=AgAAAQAAEAAA&DocType=NCA%7CCAL&fromdb=true&NCAId=236&NcaName=Magnetic+Resonance+Angiography+%28MRA%29&ver=7&year=2010
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=3
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=196&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=41&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=224&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=274&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=AgAAgAAAAAAA&ncdid=331&ncdver=1
- https://cms.gov/medicare-coverage-database/view/medicare-coverage-document.aspx?bc=16&docTypeId=7&mcdid=24&sortBy=title&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=237&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=198&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=55&sortBy=meetingdate&year=all
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=275&proposed=N
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AgAAAQAAEAAA&DocType=NCA%7CCAL&fromdb=true&NCAId=236&NcaName=Magnetic+Resonance+Angiography+%28MRA%29&ver=7&year=2010
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1198.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=83&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=331&ncdver=4
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=279&proposed=Y&type=Closed
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&ncdver=1
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=206&proposed=Y

…and more — 34 pages total ([download CSV](csv/axe-core__scope-attr-valid.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/scope-attr-valid?application=axeAPI

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=190&NCDSect=280.1&ncdver=4
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=239&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=218&proposed=N

---

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

**Bug ID:** `VS-fb5dfa13`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.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:** 24 instances; 24 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<html>
```

### Description
Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 24 of 4636 scanned pages (24 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.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/P1203.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1876.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1313.html
- https://www.cms.gov/medicaid-chip/community-engagement-support/eligibility-made-easy
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1722.html
- https://www.cms.gov/derechos-facturas-medicas/ayuda/guias/explicacion-de-beneficios
- https://www.cms.gov/data-research/cms-information-technology/tlc
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0599.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1022.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0598.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0447.html
- https://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1189.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0132.html
- https://www.cms.gov/medical-bill-rights
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0652.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0452.html
- https://cms.gov/derechos-facturas-medicas/ayuda/guias/hable-con-su-proveedor
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0510.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1573.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1550.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1164.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1176.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0098.html

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

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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1203.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1876.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1313.html

---

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

**Bug ID:** `VS-a60d40b4`  
**Pattern ID:** `VS-8806389c`  
**URL:** http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-07-03-2.html  
**XPath / selector:** `.views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 2 instances; 2 of 4636 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W37 (13 weeks)

### HTML snippet
```html
<span class="views-field views-field-field-topic" role="region" aria-label="Related search topics">
<a href="/newsroom/search?about[]=33506&amp;keys= " data-once="linkMatch">Administration</a>
</span>
```

### Description
Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 2 of 4636 scanned pages (2 instances).

### Steps to reproduce
1. Open http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-07-03-2.html.
2. Locate the element: .views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)
3. Confirm the axe-core finding for rule landmark-unique.

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

### Affected pages
- http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-07-03-2.html
- https://www.cms.gov/about-cms/contact/newsroom

### 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

### Example pages
- http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-07-03-2.html
- https://www.cms.gov/about-cms/contact/newsroom

---

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

**Bug ID:** `VS-f16c93ea`  
**Pattern ID:** `VS-0066c67d`  
**URL:** http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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:** 240 instances; 240 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<h1></h1>
```

### Description
Headings should not be empty. Detected by axe-core rule empty-heading on 240 of 4636 scanned pages (240 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0136.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0148.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0079.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0228.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0255.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2152.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0315.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0253.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0298.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0181.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0113.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0004.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0118.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0088.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0208.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0032.html

…and more — 240 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
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0076.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0188.html

---

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

**Bug ID:** `VS-7e400642`  
**Pattern ID:** `VS-d69fc059`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=218&proposed=N  
**XPath / selector:** `table[border="1"]:nth-child(99) > tbody > tr:nth-child(1) > th:nth-child(1)`  
**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:** 58 instances; 22 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<th valign="top" scope="col">&nbsp;</th>
```

### Description
Table header text should not be empty. Detected by axe-core rule empty-table-header on 22 of 4636 scanned pages (58 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=218&proposed=N.
2. Locate the element: table[border="1"]:nth-child(99) > tbody > tr:nth-child(1) > th:nth-child(1)
3. Confirm the axe-core finding for rule empty-table-header.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=218&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=165&proposed=Y&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=306&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=41&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=274&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=55&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36868&lcdStatus=all&sortBy=title&ver=25
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1198.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=36868&ver=21
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36868&lcdStatus=all&sortBy=title&ver=25
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=279&proposed=Y&type=Closed
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=231&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=292&proposed=N&sortBy=status&status=all
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1159.html
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=309
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36868&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=281&ncdver=8
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=274
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56104&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=16
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=N&type=Closed
- http://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=55&sortBy=meetingdate&year=all

### 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://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=218&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=165&proposed=Y&sortBy=status&status=all

---

## ARIA role should be appropriate for the element (WCAG criterion undetermined)

**Bug ID:** `VS-8ff1e81c`  
**Pattern ID:** `VS-4fac2f41`  
**URL:** http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html  
**XPath / selector:** `body`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `aria-allowed-role` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 2 instances; 2 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (8 weeks)

### HTML snippet
```html
<body style="background: #072137" class="cs-HTML theme-unified view-desktop is-landscape ff-on ff-drop-in-base ff-multiple-quiz-tracking ff-player-size-option sidebar-left zoom-mode timeline-playing n
```

### Description
ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 2 of 4636 scanned pages (2 instances).

### Steps to reproduce
1. Open http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html.
2. Locate the element: body
3. Confirm the axe-core finding for rule aria-allowed-role.

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

### Affected pages
- http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html
- https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.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:** Remove or change the ARIA role — it isn't allowed on this element type.

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

### Example pages
- http://cms.gov/Outreach-and-Education/MLN/WBT/MLN6447308-ICD-10-CM/icd10cm/story.html
- https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html

---

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

**Bug ID:** `VS-38116294`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all  
**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:** 615 instances; 615 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 615 of 4636 scanned pages (615 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2023-transmittals?items_per_page=25&order=field_dyna_pe_number&page=1&sort=asc
- 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/lcd.aspx?bc=6&lcdid=33996&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/newsroom/press-releases/trump-administration-releases-covid-19-checklists-tools-accelerate-relief-state-medicaid-chip
- https://cms.gov/about-cms/contact/directory/aging-center/1560246
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title
- https://cms.gov/medicare/payment/prospective-payment-systems/inpatient-rehabilitation/rules-related-files/cms-1781-f
- https://cms.gov/medicare/regulations-guidance/transmittals/2014-transmittals?items_per_page=25&order=field_dyna_release_date&page=4&sort=asc
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33906&lcdStatus=all&sortBy=title&ver=75
- https://www.cms.gov/about-cms/contact/directory/south-dakota-department-health/1562706
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10977otn
- https://www.cms.gov/about-cms/contact/directory/western-pacific-med-corp/1555071
- https://cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=7&sort=desc
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35000&ver=156
- http://www.cms.gov/newsroom/blog/cms-drug-spending-dashboards-inflation-reduction-act
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2015-transmittals-items/r3328cp
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56825&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- https://www.cms.gov/about-cms/contact/directory/american-addiction-treatment-center/1558831
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56758&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61

…and more — 615 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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=196&sortBy=status&status=all

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-76f85ccf`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all  
**XPath / selector:** `<h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 281 instances; 279 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 279 of 4636 scanned pages (281 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
2. Locate the element: <h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33996&lcdStatus=all&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57877&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33906&lcdStatus=all&sortBy=title&ver=75
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35000&ver=156
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56825&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56758&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39023&lcdStatus=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54991&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39594&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55224&articleStatus=all&bc=3&sortBy=title&ver=37
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33944&lcdStatus=all&sortBy=title&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58095&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=16
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39385&lcdStatus=all&sortBy=title&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56216&articleStatus=all&bc=3&sortBy=title&ver=4
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33718&lcdStatus=all&sortBy=title&ver=52
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34209&lcdStatus=all&sortBy=title&ver=36
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36706&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35163&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37475&ver=17
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=39

…and more — 279 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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40050&lcdStatus=all&sortBy=title&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33996&lcdStatus=all&sortBy=title&ver=33

---

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

**Bug ID:** `VS-abe7cb0f`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.cms.gov/medicare/regulations-guidance/transmittals/2023-transmittals?items_per_page=25&order=field_dyna_pe_number&page=1&sort=asc  
**XPath / selector:** `text: "Feedback"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 210 instances; 208 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 208 of 4636 scanned pages (210 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2023-transmittals?items_per_page=25&order=field_dyna_pe_number&page=1&sort=asc.
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/medicare/regulations-guidance/transmittals/2023-transmittals?items_per_page=25&order=field_dyna_pe_number&page=1&sort=asc
- 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/about-cms/contact/directory/aging-center/1560246
- https://cms.gov/medicare/payment/prospective-payment-systems/inpatient-rehabilitation/rules-related-files/cms-1781-f
- https://www.cms.gov/about-cms/contact/directory/south-dakota-department-health/1562706
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10977otn
- https://www.cms.gov/about-cms/contact/directory/western-pacific-med-corp/1555071
- http://www.cms.gov/newsroom/blog/cms-drug-spending-dashboards-inflation-reduction-act
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2015-transmittals-items/r3328cp
- https://www.cms.gov/about-cms/contact/directory/american-addiction-treatment-center/1558831
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_revision_date&page=5&sort=asc
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2015-transmittals-items/r115msp
- https://www.cms.gov/newsroom/fact-sheets/preserving-medicaid-funding-vulnerable-populations-closing-health-care-related-tax-loophole-proposed
- https://www.cms.gov/medicare/coverage/determination-process/local
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2018-transmittals-items/r2191otn
- http://cms.gov/newsroom/press-releases/cms-proposes-policy-payment-rate-changes-services-hospital-outpatient-departments-and
- https://www.cms.gov/marketplace/about/exchange-coverage-maps
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2017-transmittals-items/r3913cp
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r492pr1
- https://www.cms.gov/Medicare/Coverage/Coverage-with-Evidence-Development/LAAC
- https://cms.gov/newsroom/fact-sheets/medicaid-citizenship-guidelines
- https://www.cms.gov/cms-l564-request-employment-information
- https://www.cms.gov/about-cms/contact/cms
- https://cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/fast-facts
- http://cms.gov/data-research/monitoring-programs/medicare-risk-adjustment-data-validation-program

…and more — 208 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/medicare/regulations-guidance/transmittals/2023-transmittals?items_per_page=25&order=field_dyna_pe_number&page=1&sort=asc
- 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/about-cms/contact/directory/aging-center/1560246

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-f670d905`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all  
**XPath / selector:** `<h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r78` ([reference](https://alfa.siteimprove.com/rules/sia-r78))  
**Severity:** Moderate  
**Frequency:** 217 instances; 183 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 183 of 4636 scanned pages (217 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all.
2. Locate the element: <h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">
3. Confirm the Siteimprove Alfa finding for rule sia-r78.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57236&articleStatus=all&bc=3&sortBy=title&ver=20
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56825&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56758&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=61
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39594&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0712.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55224&articleStatus=all&bc=3&sortBy=title&ver=37
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0394.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58095&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=16
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36706&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35163&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=39
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53008&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=56
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0181.html
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54543&articleStatus=all&bc=3&sortBy=title&ver=14
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58211&ver=24
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0632.html
- https://www.cms.gov/cms-l564-request-employment-information
- http://cms.gov/data-research/monitoring-programs/medicare-risk-adjustment-data-validation-program
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1812.html
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=39284&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38664&lcdStatus=all&sortBy=title

…and more — 183 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://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0362.html
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37356&lcdStatus=all&sortBy=title

---

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

**Bug ID:** `VS-cceaa3f4`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60274&ver=6  
**XPath / selector:** `table`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 895 instances; 39 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### HTML snippet
```html
<table style="border-collapse: collapse; border: none; height: 2197px;" border="1" width="591" cellspacing="0" cellpadding="0">
<tbody>
<tr style="height: 74px;">
<td style="width: 183.922px; border: 
```

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 39 of 4636 scanned pages (895 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60274&ver=6.
2. Locate the element: table
3. Confirm the deprecated-html finding for rule presentational-attr.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60274&ver=6
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35000&lcdStatus=all&sortBy=title&ver=155
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0255.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=37054&ver=22
- http://cms.gov/icd10m/version372-fullcode-cms/fullcode_cms/P0298.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0181.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0040.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1845.html
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58456&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=39
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?ncaid=289
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55327&articleStatus=all&bc=3&sortBy=title&ver=36
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58821&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=7
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0720.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0129.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0362.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0291.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0231.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0029.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0214.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0260.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0116.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0200.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39650&lcdStatus=all&sortBy=title&ver=7
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0283.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54969&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=48

…and more — 39 pages total ([download CSV](csv/deprecated-html__presentational-attr.csv)).

### 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://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60274&ver=6
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35000&lcdStatus=all&sortBy=title&ver=155
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0255.html

---

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

**Bug ID:** `VS-c34275a2`  
**Pattern ID:** `VS-7fbb8b20`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0599.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:** 7 instances; 7 of 4636 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W37 (11 weeks)

### Description
Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 7 of 4636 scanned pages (7 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0599.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/P0599.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0598.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1189.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0652.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0452.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1550.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1176.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/P0599.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0598.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1189.html

---

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

**Bug ID:** `VS-0abc2dd7`  
**Pattern ID:** `VS-e43903a1`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0599.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:** 14 instances; 7 of 4636 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W37 (11 weeks)

### Description
Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 7 of 4636 scanned pages (14 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0599.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/P0599.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0598.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1189.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0652.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0452.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1550.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1176.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/P0599.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0598.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1189.html

---

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

**Bug ID:** `VS-dfac98d4`  
**Pattern ID:** `VS-4c341c77`  
**URL:** https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218  
**XPath / selector:** `<p>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r85` ([reference](https://alfa.siteimprove.com/rules/sia-r85))  
**Severity:** Moderate  
**Frequency:** 12 instances; 4 of 4636 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W37 (13 weeks)

### Description
Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 4 of 4636 scanned pages (12 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218.
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://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?ncaid=265
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=281&ncdver=8

### 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

### Example pages
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?fromTracking=Y&ncaId=218
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?ncaid=265

---

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

**Bug ID:** `VS-53f24a96`  
**Pattern ID:** `VS-f2542d87`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all  
**XPath / selector:** `<pre>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r79` ([reference](https://alfa.siteimprove.com/rules/sia-r79))  
**Severity:** Moderate  
**Frequency:** 3 instances; 3 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (14 weeks)

### Description
Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 3 of 4636 scanned pages (3 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all.
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://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=196&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=224&proposed=N

### 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://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=196&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=224&proposed=N

---

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

**Bug ID:** `VS-fe0e15b5`  
**Pattern ID:** `VS-3d033717`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all  
**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 4636 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W37 (12 weeks)

### Description
No obsolete or deprecated elements are used. Detected by Siteimprove Alfa rule sia-r70 on 3 of 4636 scanned pages (3 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all.
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
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53064&ver=87
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=281&ncdver=8

### 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
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=277&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53064&ver=87
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=281&ncdver=8

---

## aria attribute is defined in WAI-ARIA (WCAG criterion undetermined)

**Bug ID:** `VS-deaceced`  
**Pattern ID:** `VS-7f897be7`  
**URL:** https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html  
**XPath / selector:** `@aria-role="scrollbar"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r20` ([reference](https://alfa.siteimprove.com/rules/sia-r20))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 4636 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W37 (3 weeks)

### Description
aria attribute is defined in WAI-ARIA. Detected by Siteimprove Alfa rule sia-r20 on 1 of 4636 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html.
2. Locate the element: @aria-role="scrollbar"
3. Confirm the Siteimprove Alfa finding for rule sia-r20.

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

### Affected pages
- https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.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-r20

---

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

**Bug ID:** `VS-d976eafa`  
**Pattern ID:** `VS-aa242c2d`  
**URL:** https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html  
**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:** 1 instances; 1 of 4636 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W37 (9 weeks)

### Description
First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 1 of 4636 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.html.
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/Outreach-and-Education/MLN/WBT/MLN3995723-MLNPartsCD/FWA/story.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-r87

---

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

**Bug ID:** `VS-00d2d30b`  
**Pattern ID:** `VS-91d2294a`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53064&ver=87  
**XPath / selector:** `font`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `font-element`  
**Severity:** Moderate  
**Frequency:** 4 instances; 1 of 4636 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W37 (12 weeks)

### HTML snippet
```html
<font face="Times New Roman" size="3"><span style="line-height: 115%; font-family: &quot;Times New Roman&quot;,&quot;serif&quot;; font-size: 12pt;">Under <b><i style="mso-bidi-font-style: normal;">CPT
```

### Description
Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 1 of 4636 scanned pages (4 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53064&ver=87.
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
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=53064&ver=87

### 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.