# Accessibility bug reports — www.cms.gov, week 2026-W38

51 issue type(s) from 4664 pages scanned. Generated 2026-09-30 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-a955bf79`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.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:** 395 instances; 103 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 103 of 4664 scanned pages (395 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.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
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53026&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=62
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59828&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57891&articleStatus=all&bc=3&sortBy=title&ver=32
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=102&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37313&ver=28
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0043.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0357.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1785.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53446&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleId=60357&ver=4
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0076.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39434&ver=7
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53605&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=21
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0309.html
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56232&articleStatus=all&bc=3&sortBy=title&ver=34
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=14

…and more — 103 pages total ([download CSV](csv/alfa__sia-r113.csv)).

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

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

### Example pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33

---

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

**Bug ID:** `VS-dd11cd3f`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2  
**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:** 481 instances; 189 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 189 of 4664 scanned pages (481 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2.
2. Locate the element: <a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58113&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53026&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=62
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59828&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57891&articleStatus=all&bc=3&sortBy=title&ver=32
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=102&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37293&lcdStatus=all&sortBy=title&ver=28
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37313&ver=28
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33394&lcdStatus=all&sortBy=title&ver=50
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38792&lcdStatus=all&sortBy=title&ver=6
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53446&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleId=60357&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39434&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39242&sortBy=relevance&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=36139&sortBy=relevance&ver=30
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=340&ncdver=1
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36544&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37863&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=AiAAAAAACAAAAA%3D%3D&ExpandComments=n&NCAId=267&NcaName=Cardiac+Pacemakers*3a%24+Single-Chamber+and+Dual-Chamber+Permanent+Cardiac+Pacemakers+%283rd+Recon%29
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38918&lcdStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53605&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=21

…and more — 189 pages total ([download CSV](csv/alfa__sia-r14.csv)).

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14

### Example pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-8b7fb0ff`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.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:** 295 instances; 294 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (14 weeks)

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

### Description
Images must have alternative text. Detected by axe-core rule image-alt on 294 of 4664 scanned pages (295 instances).

### Steps to reproduce
1. Open http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.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://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0210.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0202.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0060.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P1036.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0238.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0240.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0131.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0271.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0263.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0096.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2161.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0211.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0099.html

…and more — 294 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://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-a58f673c`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.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:** 55 instances; 55 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (14 weeks)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 55 of 4664 scanned pages (55 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html.
2. Locate the element: <img src="cms-site-logo.png">
3. Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

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

### Affected pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0043.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0357.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1785.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0076.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0309.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0053.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1847.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0719.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0259.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0046.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0051.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0175.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0129.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0215.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0282.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0029.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0562.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0655.html

…and more — 55 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
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html

---

## Certain ARIA roles must contain particular children (WCAG 1.3.1)

**Bug ID:** `VS-a301806f`  
**Pattern ID:** `VS-9429bb8d`  
**URL:** http://cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html  
**XPath / selector:** `#SERVICES`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `aria-required-children` ([reference](https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI))  
**Severity:** Critical  
**Frequency:** 1 instances; 1 of 4664 pages affected
  
**History:** first seen 2026-W28, last seen 2026-W38 (3 weeks)

### HTML snippet
```html
<ul id="SERVICES" class="closed openMenu" role="menu" tabindex="-1" style="background-color: rgb(255, 255, 255); margin-bottom: 60px;">
```

### Description
Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 1 of 4664 scanned pages (1 instances).

### Steps to reproduce
1. Open http://cms.gov/Medicare/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.html.
2. Locate the element: #SERVICES
3. Confirm the axe-core finding for rule aria-required-children 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/Prevention/PrevntionGenInfo/medicare-preventive-services/MPS-QuickReferenceChart-1.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:** Add the child roles this container role requires (e.g. a list needs listitem children).

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

---

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

**Bug ID:** `VS-2c79cab2`  
**Pattern ID:** `VS-a0bdbdf6`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19  
**XPath / selector:** `#lblCmsNationalCoveragePolicy > ul:nth-child(2)`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** axe-core — `list` ([reference](https://dequeuniversity.com/rules/axe/4.12/list?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1344 instances; 254 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

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

### Description
<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 254 of 4664 scanned pages (1344 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19.
2. Locate the element: #lblCmsNationalCoveragePolicy > ul:nth-child(2)
3. Confirm the axe-core finding for rule list against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53033&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=139
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34520&lcdStatus=all&sortBy=title&ver=32
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57069&articleStatus=all&bc=3&sortBy=title&ver=24
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38803&lcdStatus=all&sortBy=title&ver=16
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=258&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=33619&ver=25
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33563&lcdStatus=all&sortBy=title&stateRegion=all&ver=27
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38671&lcdStatus=all&sortBy=title&ver=7
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34646&lcdStatus=all&sortBy=title&stateRegion=all&ver=26
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34399&lcdStatus=all&sortBy=title&ver=29
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=60318&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=5
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39258&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59828&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34196&lcdStatus=all&sortBy=title&ver=30
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33398&lcdStatus=all&sortBy=title&ver=35
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33733&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56642&ver=47
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38387&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=33632&ver=83
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33796&lcdStatus=all&sortBy=title&ver=24
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37293&lcdStatus=all&sortBy=title&ver=28
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?areaId=all&articleid=56340&bc=1&contractOption=all&docType=NCA%2CCAL%2CNCD%2CMEDCAC%2CTA%2CMCD%2C6%2C3%2C5%2C1%2CF%2CP&keyword=permanent+cardiac&keywordType=starts&sortBy=relevance&ver=30
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=33577&ver=44

…and more — 254 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://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53033&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=139
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34520&lcdStatus=all&sortBy=title&ver=32

---

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

**Bug ID:** `VS-03e63d88`  
**Pattern ID:** `VS-6175596b`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19  
**XPath / selector:** `i > 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:** 198 instances; 5 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

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

### Description
<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 5 of 4664 scanned pages (198 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19.
2. Locate the element: i > 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
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=282&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=NCA&ncaid=293&proposed=N&sortBy=status&status=Open+for+Public+Comment
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=317&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=288

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

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=282&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=NCA&ncaid=293&proposed=N&sortBy=status&status=Open+for+Public+Comment

---

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

**Bug ID:** `VS-bfc90016`  
**Pattern ID:** `VS-07ba3b17`  
**URL:** https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&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:** 2 instances; 2 of 4664 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W38 (14 weeks)

### HTML snippet
```html
<table class="MsoTableGrid">
```

### Description
Table cell headers attributes must refer to other <th> elements in the same tabl. Detected by axe-core rule td-headers-attr on 2 of 4664 scanned pages (2 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&page=0&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&page=0&sort=desc
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=5&sort=desc

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

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

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

### Example pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2022-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=0&sort=desc
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=5&sort=desc

---

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

**Bug ID:** `VS-9b72e82a`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html  
**XPath / selector:** `<tr>`  
**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:** 216 instances; 60 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 60 of 4664 scanned pages (216 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html.
2. Locate the element: <tr>
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://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0043.html
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37863&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=AiAAAAAACAAAAA%3D%3D&ExpandComments=n&NCAId=267&NcaName=Cardiac+Pacemakers*3a%24+Single-Chamber+and+Dual-Chamber+Permanent+Cardiac+Pacemakers+%283rd+Recon%29
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39933&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=87&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=36577&lcdStatus=all&sortBy=title
- http://www.cms.gov/medicare-coverage-database/reports/national-coverage-ncacal-status-report.aspx?ncacaldoctype=all&status=Open+for+Public+Comment
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=34393&lcdStatus=all&sortBy=title&stateRegion=all
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34337&lcdStatus=all&sortBy=title&ver=24
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=40341&lcdStatus=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57843&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33461&lcdStatus=all&sortBy=title&ver=64
- https://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=40302&sortBy=relevance
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33946&lcdStatus=all&sortBy=title&stateRegion=all&ver=16
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37254&lcdStatus=all&sortBy=title&stateRegion=all&ver=16
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33616&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=35130&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=38664&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38623&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56786&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1209&ver=77
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37033&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38773&lcdStatus=all&sortBy=title&ver=27
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0018.html

…and more — 60 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://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0043.html

---

## Element has required owned roles (WCAG 1.3.1)

**Bug ID:** `VS-d8d82b1c`  
**Pattern ID:** `VS-3c632d31`  
**URL:** https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.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:** 55 instances; 55 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 55 of 4664 scanned pages (55 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html.
2. Locate the element: <h1>
3. Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0043.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0357.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1785.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0076.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0309.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0053.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1847.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0719.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0259.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0046.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0051.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0175.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0129.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0215.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0282.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0029.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0562.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0655.html

…and more — 55 pages total ([download CSV](csv/alfa__sia-r64.csv)).

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

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

### Example pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html

---

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

**Bug ID:** `VS-8dd542f7`  
**Pattern ID:** `VS-4408605e`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26  
**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:** 30 instances; 18 of 4664 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W38 (14 weeks)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 18 of 4664 scanned pages (30 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26.
2. Locate the element: <th scope="col">
3. Confirm the Siteimprove Alfa finding for rule sia-r46 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53026&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=62
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57891&articleStatus=all&bc=3&sortBy=title&ver=32
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56433&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=80
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57132&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=19
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57843&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=12
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54926&articleStatus=all&bc=3&sortBy=title&ver=25
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56786&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1209&ver=77
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53001&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=45
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57633&articleStatus=all&bc=3&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57690&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=38
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53056&ver=15
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=5&sort=desc
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?areaId=all&articleid=57193&bc=1&contractOption=all&docType=6%2C1&keyword=foot+care&keywordType=starts&sortBy=relevance&ver=30
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56796&articleStatus=all&bc=3&sortBy=title&ver=31
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57600&ver=27
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57069&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://www.cms.gov/medicare/quality/value-based-programs/value-based-purchasing-snf-vbp-program/spotlights-announcements

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r46

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53026&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=62
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57891&articleStatus=all&bc=3&sortBy=title&ver=32

---

## Table cell has header (WCAG 1.3.1)

**Bug ID:** `VS-12fb485e`  
**Pattern ID:** `VS-3f067795`  
**URL:** https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=Y&type=Closed  
**XPath / selector:** `<td>`  
**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:** 4 instances; 3 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 3 of 4664 scanned pages (4 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=Y&type=Closed.
2. Locate the element: <td>
3. Confirm the Siteimprove Alfa finding for rule sia-r77 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=Y&type=Closed
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1686.html
- https://www.cms.gov/medicare/quality/value-based-programs/value-based-purchasing-snf-vbp-program/spotlights-announcements

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=Y&type=Closed
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1686.html
- https://www.cms.gov/medicare/quality/value-based-programs/value-based-purchasing-snf-vbp-program/spotlights-announcements

---

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

**Bug ID:** `VS-181d7ef3`  
**Pattern ID:** `VS-9207ed51`  
**URL:** https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=5&sort=desc  
**XPath / selector:** `@headers="view-field-dyna-revision-date-table-column"`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r45` ([reference](https://alfa.siteimprove.com/rules/sia-r45))  
**Severity:** Moderate  
**Frequency:** 197 instances; 1 of 4664 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W38 (8 weeks)

### Description
aria-hidden element is not exposed to assistive technology. Detected by Siteimprove Alfa rule sia-r45 on 1 of 4664 scanned pages (197 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=5&sort=desc.
2. Locate the element: @headers="view-field-dyna-revision-date-table-column"
3. Confirm the Siteimprove Alfa finding for rule sia-r45 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=5&sort=desc

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r45

---

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

**Bug ID:** `VS-5b2b007c`  
**Pattern ID:** `VS-8ade3360`  
**URL:** http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13  
**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:** 965 instances; 424 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### HTML snippet
```html
<a href="https://localcoverage.cms.gov/mcd_archive/view/lcd.aspx?lcdInfo=39769:5" target="_blank" class="log-click system-link" data-page-action="Clicked the Source Proposed LCD link">DL39770</a>
```

### Description
Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 424 of 4664 scanned pages (965 instances).

### Steps to reproduce
1. Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13.
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
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37779&lcdStatus=all&sortBy=title&stateRegion=all&ver=16
- http://cms.gov/medicare-coverage-database/view/cal.aspx?calid=185
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36339&lcdStatus=all&sortBy=title&stateRegion=all&ver=23
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39464&sortBy=relevance&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38803&lcdStatus=all&sortBy=title&ver=16
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34213&lcdStatus=all&sortBy=title&ver=56
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35761&lcdStatus=all&sortBy=title&stateRegion=all&ver=38
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=39905&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38671&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=36577&ver=16
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37033&lcdStatus=all&sortBy=title&ver=30
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38335&lcdStatus=all&sortBy=title&ver=15
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=239&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=33318&proposedStatus=all&sortBy=title&ver=63
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39258&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38926&lcdStatus=all&sortBy=title&ver=20
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40384&proposedStatus=all&sortBy=title&stateRegion=all&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=40052&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39402&lcdStatus=all&sortBy=title&ver=14
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33398&lcdStatus=all&sortBy=title&ver=35
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39462&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38387&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33796&lcdStatus=all&sortBy=title&ver=24

…and more — 424 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
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39770&lcdStatus=all&sortBy=title&ver=13
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37779&lcdStatus=all&sortBy=title&stateRegion=all&ver=16
- http://cms.gov/medicare-coverage-database/view/cal.aspx?calid=185

---

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

**Bug ID:** `VS-9b813573`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33394&lcdStatus=all&sortBy=title&ver=50  
**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:** 12 instances; 6 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (14 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 6 of 4664 scanned pages (12 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33394&lcdStatus=all&sortBy=title&ver=50.
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://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33394&lcdStatus=all&sortBy=title&ver=50
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39242&sortBy=relevance&ver=5
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59649&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=36707&ver=39
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=40173&proposedStatus=all&sortBy=title&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56926&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=15

### 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://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33394&lcdStatus=all&sortBy=title&ver=50
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39242&sortBy=relevance&ver=5
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59649&ver=19

---

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

**Bug ID:** `VS-f265b0f6`  
**Pattern ID:** `VS-c613c153`  
**URL:** https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=230&proposed=N  
**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:** 1 instances; 1 of 4664 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W38 (10 weeks)

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

### Description
Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 1 of 4664 scanned pages (1 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=230&proposed=N.
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://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=230&proposed=N

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

### Suggested fix
**How to fix:** 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

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-5e5751f9`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** http://cms.gov/data-research/cms-data/learn-more-about-cms-data  
**XPath / selector:** `p:nth-child(12) > a[target="_blank"][data-entity-substitution="canonical"][data-entity-type="node"]`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** axe-core — `link-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 6 instances; 4 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### HTML snippet
```html
<a href="/data-research/cms-data/qualified-entity-program" target="_blank" data-entity-substitution="canonical" data-entity-type="node" data-entity-uuid="bc2a682a-8a5c-4bf6-ab96-775413fb703f" data-onc
```

### Description
Links must have discernible text. Detected by axe-core rule link-name on 4 of 4664 scanned pages (6 instances).

### Steps to reproduce
1. Open http://cms.gov/data-research/cms-data/learn-more-about-cms-data.
2. Locate the element: p:nth-child(12) > a[target="_blank"][data-entity-substitution="canonical"][data-entity-type="node"]
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://cms.gov/data-research/cms-data/learn-more-about-cms-data
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=317&proposed=N&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=321&proposed=Y

### 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://cms.gov/data-research/cms-data/learn-more-about-cms-data
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=317&proposed=N&sortBy=status&status=all

---

## Link has accessible name (WCAG 2.4.4)

**Bug ID:** `VS-bd64c680`  
**Pattern ID:** `VS-28ebd979`  
**URL:** http://cms.gov/data-research/cms-data/learn-more-about-cms-data  
**XPath / selector:** `<a href="/data-research/cms-data/qualified-entity-program" target="_blank" data-entity-substitution="canonical" data-entity-type="node">`  
**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 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (13 weeks)

### Description
Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 4664 scanned pages (1 instances).

### Steps to reproduce
1. Open http://cms.gov/data-research/cms-data/learn-more-about-cms-data.
2. Locate the element: <a href="/data-research/cms-data/qualified-entity-program" target="_blank" data-entity-substitution="canonical" data-entity-type="node">
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://cms.gov/data-research/cms-data/learn-more-about-cms-data

### 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-d3d81fae`  
**Pattern ID:** `VS-c126b6a6`  
**URL:** http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.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:** 305 instances; 305 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

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

### Description
<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 305 of 4664 scanned pages (305 instances).

### Steps to reproduce
1. Open http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.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://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0210.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0202.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0060.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P1036.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0238.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0240.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0131.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0271.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0263.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0096.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2161.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0211.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0099.html

…and more — 305 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://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html

---

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

**Bug ID:** `VS-503d9f31`  
**Pattern ID:** `VS-7a0e5645`  
**URL:** https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.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:** 56 instances; 56 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 56 of 4664 scanned pages (56 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html.
2. Locate the element: <html>
3. Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page.

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

### Affected pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0043.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0357.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1785.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0076.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0309.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0053.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1847.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0719.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0259.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0001.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0046.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0617.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0051.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0175.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0129.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0215.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0282.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0029.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0562.html

…and more — 56 pages total ([download CSV](csv/alfa__sia-r4.csv)).

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

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

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

### Example pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html

---

## Form elements must have labels (WCAG 4.1.2)

**Bug ID:** `VS-a1cb7157`  
**Pattern ID:** `VS-fafffee0`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1462.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:** 12 instances; 12 of 4664 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W38 (13 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 12 of 4664 scanned pages (12 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1462.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/P1462.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0113.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0384.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1522.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0617.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0341.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0165.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0083.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1160.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0971.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1298.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1134.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/P1462.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0113.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0384.html

---

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

**Bug ID:** `VS-a95beaad`  
**Pattern ID:** `VS-58301a87`  
**URL:** https://cms.gov/files/linked-video-files/new-features-medicare-gov  
**XPath / selector:** `.ytPageHeaderViewModelScrollContainer > .ytPageHeaderViewModelContent > .ytPageHeaderViewModelHeadline > .ytPageHeaderViewModelHeadlineInfo > .ytPageHeaderViewModelContentMetadata.ytPageHeaderViewModelContentMetadataOverlay > .ytContentMetadataViewModelMetadataRow[role="group"]:nth-child(1) > yt-avatar-stack-view-model`  
**WCAG SC:** 4.1.2 — Name, Role, Value (Level A)  
**Rule:** axe-core — `nested-interactive` ([reference](https://dequeuniversity.com/rules/axe/4.12/nested-interactive?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 4664 pages affected
  
**History:** first seen 2026-W33, last seen 2026-W38 (2 weeks)

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

### Description
Interactive controls must not be nested. Detected by axe-core rule nested-interactive on 1 of 4664 scanned pages (1 instances).

### Steps to reproduce
1. Open https://cms.gov/files/linked-video-files/new-features-medicare-gov.
2. Locate the element: .ytPageHeaderViewModelScrollContainer > .ytPageHeaderViewModelContent > .ytPageHeaderViewModelHeadline > .ytPageHeaderViewModelHeadlineInfo > .ytPageHeaderViewModelContentMetadata.ytPageHeaderViewModelContentMetadataOverlay > .ytContentMetadataViewModelMetadataRow[role="group"]:nth-child(1) > yt-avatar-stack-view-model
3. Confirm the axe-core finding for rule nested-interactive against WCAG 4.1.2 Name, Role, Value.

### Impact
Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).
- **Without vision** (1.0% of population)
- **Limited vision** (2.4% of population)
- **Limited manipulation/strength** (13.0% of population)

### Affected pages
- https://cms.gov/files/linked-video-files/new-features-medicare-gov

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

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

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

---

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

**Bug ID:** `VS-27ba545a`  
**Pattern ID:** `VS-be8d563e`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39464&sortBy=relevance&ver=7  
**XPath / selector:** `td[rowspan="2"]:nth-child(1) > p`  
**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:** 510 instances; 34 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### HTML snippet
```html
<p style="text-align: center;">Outcomes</p>
```

### Description
Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 34 of 4664 scanned pages (510 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39464&sortBy=relevance&ver=7.
2. Locate the element: td[rowspan="2"]:nth-child(1) > p
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/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39464&sortBy=relevance&ver=7
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=33318&proposedStatus=all&sortBy=title&ver=63
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39402&lcdStatus=all&sortBy=title&ver=14
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0211.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39462&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=304&proposed=N
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0024.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=268&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=309&proposed=N&sortBy=status&status=all
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0028.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33803&lcdStatus=all&sortBy=title&stateRegion=all&ver=61
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37870&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33624&lcdStatus=all&sortBy=title&stateRegion=all&ver=34
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0633.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37870&lcdStatus=all&sortBy=title&ver=19
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37870&lcdStatus=all&sortBy=title&stateRegion=all&ver=19
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0215.html
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=33318&proposedStatus=all&sortBy=title&stateRegion=all&ver=63
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=NCA&ncaid=293&proposed=N&sortBy=status&status=Open+for+Public+Comment
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=317&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52521&ver=48
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=34
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=295&proposed=N&sortBy=status&status=all
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0237.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0302.html

…and more — 34 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/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39464&sortBy=relevance&ver=7
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=33318&proposedStatus=all&sortBy=title&ver=63
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39402&lcdStatus=all&sortBy=title&ver=14

---

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

**Bug ID:** `VS-74ba4388`  
**Pattern ID:** `VS-f7e99f4b`  
**URL:** https://www.cms.gov/medical-bill-rights/help/submit-a-complaint/get-started  
**XPath / selector:** `text: "Pages in this section"`  
**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:** 2 instances; 2 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 2 of 4664 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medical-bill-rights/help/submit-a-complaint/get-started.
2. Locate the element: text: "Pages in this section"
3. Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum).

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

### Affected pages
- https://www.cms.gov/medical-bill-rights/help/submit-a-complaint/get-started
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=34

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

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

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

### Example pages
- https://www.cms.gov/medical-bill-rights/help/submit-a-complaint/get-started
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33624&lcdStatus=all&sortBy=title&ver=34

---

## 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 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 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 4664 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 4664 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W38 (7 weeks)

### Description
Element with lang attribute has correct language. Detected by Siteimprove Alfa rule sia-r7 on 1 of 4664 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-1827b8a8`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2  
**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:** 1073 instances; 190 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 190 of 4664 scanned pages (1073 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2.
2. Locate the element: text: "Here's how you know"
3. Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58113&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53026&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=62
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59828&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57891&articleStatus=all&bc=3&sortBy=title&ver=32
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=102&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37293&lcdStatus=all&sortBy=title&ver=28
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37313&ver=28
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33394&lcdStatus=all&sortBy=title&ver=50
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38792&lcdStatus=all&sortBy=title&ver=6
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53446&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- https://www.cms.gov/medical-bill-rights/help/submit-a-complaint/get-started
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleId=60357&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39434&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39242&sortBy=relevance&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=36139&sortBy=relevance&ver=30
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=340&ncdver=1
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36544&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37863&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=AiAAAAAACAAAAA%3D%3D&ExpandComments=n&NCAId=267&NcaName=Cardiac+Pacemakers*3a%24+Single-Chamber+and+Dual-Chamber+Permanent+Cardiac+Pacemakers+%283rd+Recon%29
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38918&lcdStatus=all&sortBy=title&ver=8

…and more — 190 pages total ([download CSV](csv/alfa__sia-r66.csv)).

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

### Suggested fix
**How to fix:** Increase text contrast to meet WCAG AAA (7:1).

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33

---

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

**Bug ID:** `VS-b6d90ef7`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc  
**XPath / selector:** `<p class="ds-c-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:** 5866 instances; 484 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 484 of 4664 scanned pages (5866 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc.
2. Locate the element: <p class="ds-c-usa-banner__header-text">
3. Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc
- https://cms.gov/about-cms/work-with-us/careers/positions
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals/r12626otn
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10737cp
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- https://www.cms.gov/medicare/forms-notices/cms-forms-list
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58113&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/initiatives/health-technology-ecosystem/overview/medicare-app-library
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- https://cms.gov/medicare/regulations-guidance/physician-self-referral/self-referral-disclosure-protocol-settlements
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- http://www.cms.gov/apps/ama/license.asp?file=%2FResearch-Statistics-Data-and-Systems%2FStatistics-Trends-and-Reports%2FMedicareMedicaidStatSupp%2FDownloads%2F2005_Table70.pdf
- http://cms.gov/medicare/medicare-fee-for-service-payment/physicianfeedbackprogram/2012-supplemental-qrur
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10269cp
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2016-transmittals?items_per_page=25&order=field_dyna_subject_formatted&sort=desc
- https://www.cms.gov/medicare/coverage/determination-process/local
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2013-transmittals-items/r1174otn
- https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72

…and more — 484 pages total ([download CSV](csv/alfa__sia-r73.csv)).

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

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

### Example pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc
- https://cms.gov/about-cms/work-with-us/careers/positions
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html

---

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

**Bug ID:** `VS-bccb1752`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2  
**XPath / selector:** `<p class="mb-2">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r74` ([reference](https://alfa.siteimprove.com/rules/sia-r74))  
**Severity:** Moderate  
**Frequency:** 13131 instances; 190 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 190 of 4664 scanned pages (13131 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2.
2. Locate the element: <p class="mb-2">
3. Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58113&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53026&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=62
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59828&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57891&articleStatus=all&bc=3&sortBy=title&ver=32
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=102&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37293&lcdStatus=all&sortBy=title&ver=28
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37313&ver=28
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33394&lcdStatus=all&sortBy=title&ver=50
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38792&lcdStatus=all&sortBy=title&ver=6
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53446&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleId=60357&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39434&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39242&sortBy=relevance&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=36139&sortBy=relevance&ver=30
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=340&ncdver=1
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36544&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37863&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=AiAAAAAACAAAAA%3D%3D&ExpandComments=n&NCAId=267&NcaName=Cardiac+Pacemakers*3a%24+Single-Chamber+and+Dual-Chamber+Permanent+Cardiac+Pacemakers+%283rd+Recon%29
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38918&lcdStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53605&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=21

…and more — 190 pages total ([download CSV](csv/alfa__sia-r74.csv)).

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74

### Example pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33

---

## Scrollable element is keyboard accessible (WCAG 1.4.8)

**Bug ID:** `VS-d284b917`  
**Pattern ID:** `VS-388b5438`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39434&ver=7  
**XPath / selector:** `<p style="line-height: 14.15pt;">`  
**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:** 456 instances; 16 of 4664 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W38 (14 weeks)

### Description
Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 16 of 4664 scanned pages (456 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39434&ver=7.
2. Locate the element: <p style="line-height: 14.15pt;">
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?lcdid=39434&ver=7
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59695&articleStatus=all&bc=3&sortBy=title&ver=5
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56199&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=115
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=40341&lcdStatus=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38051&lcdStatus=all&sortBy=title&stateRegion=all&ver=17
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38773&lcdStatus=all&sortBy=title&ver=27
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37913&lcdStatus=all&sortBy=title&ver=15
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38584&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39642&lcdStatus=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=38705&proposedStatus=all&sortBy=title&stateRegion=all&ver=7
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59353&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=5
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39642&lcdStatus=all&sortBy=title&ver=10
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38777&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52514&ver=61
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59695&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=5

### 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?lcdid=39434&ver=7
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59695&articleStatus=all&bc=3&sortBy=title&ver=5

---

## iframe element is not empty (WCAG 1.4.8)

**Bug ID:** `VS-af83c823`  
**Pattern ID:** `VS-48291402`  
**URL:** http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=14  
**XPath / selector:** `<p style="text-align: justify;">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r71` ([reference](https://alfa.siteimprove.com/rules/sia-r71))  
**Severity:** Moderate  
**Frequency:** 59 instances; 6 of 4664 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W38 (14 weeks)

### Description
iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 6 of 4664 scanned pages (59 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=14.
2. Locate the element: <p style="text-align: justify;">
3. Confirm the Siteimprove Alfa finding for rule sia-r71 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38051&lcdStatus=all&sortBy=title&stateRegion=all&ver=17
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38773&lcdStatus=all&sortBy=title&ver=27
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39297&lcdStatus=all&sortBy=title&stateRegion=all&ver=7
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59353&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38988&lcdStatus=all&sortBy=title&stateRegion=all&ver=18

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

### Suggested fix
See remediation guidance: https://alfa.siteimprove.com/rules/sia-r71

### Example pages
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38051&lcdStatus=all&sortBy=title&stateRegion=all&ver=17
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38773&lcdStatus=all&sortBy=title&ver=27

---

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

**Bug ID:** `VS-4ad50af1`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc  
**XPath / selector:** `<a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">`  
**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:** 16513 instances; 491 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 491 of 4664 scanned pages (16513 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc.
2. Locate the element: <a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">
3. Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

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

### Affected pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc
- https://cms.gov/about-cms/work-with-us/careers/positions
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals/r12626otn
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10737cp
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- https://www.cms.gov/medicare/forms-notices/cms-forms-list
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58113&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/initiatives/health-technology-ecosystem/overview/medicare-app-library
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- https://cms.gov/medicare/regulations-guidance/physician-self-referral/self-referral-disclosure-protocol-settlements
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- http://www.cms.gov/apps/ama/license.asp?file=%2FResearch-Statistics-Data-and-Systems%2FStatistics-Trends-and-Reports%2FMedicareMedicaidStatSupp%2FDownloads%2F2005_Table70.pdf
- http://cms.gov/medicare/medicare-fee-for-service-payment/physicianfeedbackprogram/2012-supplemental-qrur
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10269cp
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2016-transmittals?items_per_page=25&order=field_dyna_subject_formatted&sort=desc
- https://www.cms.gov/medicare/coverage/determination-process/local
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2013-transmittals-items/r1174otn
- https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72

…and more — 491 pages total ([download CSV](csv/alfa__sia-r111.csv)).

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

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

### Example pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc
- https://cms.gov/about-cms/work-with-us/careers/positions
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html

---

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

**Bug ID:** `VS-68047ab5`  
**Pattern ID:** `VS-bd13f00a`  
**URL:** https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html  
**XPath / selector:** `td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0368.html"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `accesskeys` ([reference](https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 288 instances; 98 of 4664 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W38 (12 weeks)

### HTML snippet
```html
<a accesskey="p" id="prev_page" href="P0368.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 98 of 4664 scanned pages (288 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html.
2. Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0368.html"]
3. Confirm the axe-core finding for rule accesskeys.

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

### Affected pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0271.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2161.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0211.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1785.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1839.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0153.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0230.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1138.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0330.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0946.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1257.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0498.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0309.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0002.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P0398.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1213.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0024.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0389.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0088.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1890.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1855.html

…and more — 98 pages total ([download CSV](csv/axe-core__accesskeys.csv)).

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

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

### Example pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0027.html

---

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

**Bug ID:** `VS-c1e86e3b`  
**Pattern ID:** `VS-f18df681`  
**URL:** http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.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:** 5687 instances; 307 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 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 v40.1 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 307 of 4664 scanned pages (5687 instances).

### Steps to reproduce
1. Open http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.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://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0210.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0202.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0060.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P1036.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0238.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0240.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0131.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0271.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0263.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0096.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2161.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0211.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0099.html

…and more — 307 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://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html

---

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

**Bug ID:** `VS-39f3a6ee`  
**Pattern ID:** `VS-d5d82446`  
**URL:** http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.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:** 305 instances; 305 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

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

### Description
Document should have one main landmark. Detected by axe-core rule landmark-one-main on 305 of 4664 scanned pages (305 instances).

### Steps to reproduce
1. Open http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.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://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0210.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0202.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0060.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P1036.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0238.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0240.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0131.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0271.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0263.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0096.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2161.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0211.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0099.html

…and more — 305 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://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html

---

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

**Bug ID:** `VS-527e4804`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-alphabetical-report.aspx?proposedStatus=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:** 280 instances; 277 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 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 277 of 4664 scanned pages (280 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-alphabetical-report.aspx?proposedStatus=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://cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-alphabetical-report.aspx?proposedStatus=all
- http://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33411&lcdStatus=all&sortBy=title
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=258&proposed=Y
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38288&lcdStatus=all&sortBy=title&stateRegion=all
- http://www.cms.gov/apps/ama/license.asp?file=%2FResearch-Statistics-Data-and-Systems%2FStatistics-Trends-and-Reports%2FMedicareMedicaidStatSupp%2FDownloads%2F2005_Table70.pdf
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33622&lcdStatus=all&sortBy=title
- http://www.cms.gov/apps/ama/license.asp?file=%2Ffiles%2Fzip%2Fupdated-list-codes-effective-january-1-2024-published-march-1-2024.zip
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=34646&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39314&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=233&proposed=N&type=Closed
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=36538&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35099&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33802&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=38201&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33693&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38678&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38769&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=6&proposed=N
- http://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=39948&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=40334&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36767&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39799&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/license/ama?file=%2Ffiles%2Fzip%2Fapril-2025-update-hospital-outpatient-prospective-payment-system-opps.zip
- https://cms.gov/files/linked-video-files/new-features-medicare-gov

…and more — 277 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://cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-alphabetical-report.aspx?proposedStatus=all
- http://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33411&lcdStatus=all&sortBy=title
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities

---

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

**Bug ID:** `VS-da77ec2b`  
**Pattern ID:** `VS-0ba8ce9d`  
**URL:** https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=258&proposed=Y  
**XPath / selector:** `tr:nth-child(2) > td[scope="row"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `scope-attr-valid` ([reference](https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 850 instances; 42 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### HTML snippet
```html
<td valign="top" scope="row">September  30, 2011</td>
```

### Description
scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 42 of 4664 scanned pages (850 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=258&proposed=Y.
2. Locate the element: tr:nth-child(2) > td[scope="row"]
3. Confirm the axe-core finding for rule scope-attr-valid.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=258&proposed=Y
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=233&proposed=N&type=Closed
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1138.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=282&proposed=N&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=331&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=268&proposed=Y&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=Y&type=Closed
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1178.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=265&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=101&proposed=N&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=230&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=237&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=239&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=47&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAEACA&docName=Decision+Memo+for+Cardiac+Pacemakers+%28CAG-00063R2%29&NCAId=267&NcaName=Cardiac+Pacemakers+%282nd+Recon%29&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=198&proposed=N&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=202&proposed=Y
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=265
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=24&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?bc=BEAAAAAAEAAA&fromdb=true&NCAId=215&NcaName=Thermal+Intradiscal+Procedures&ver=10
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=64&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=236&proposed=Y
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=85&proposed=N&type=Closed
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=50&proposed=N
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=218&proposed=Y

…and more — 42 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://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=258&proposed=Y
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=233&proposed=N&type=Closed
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1138.html

---

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

**Bug ID:** `VS-2872563b`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1462.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:** 18 instances; 18 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

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

### Description
Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 18 of 4664 scanned pages (18 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1462.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/P1462.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0113.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0384.html
- https://www.cms.gov/medicaid-chip/community-engagement-support/eligibility-made-easy
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1522.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/P0617.html
- http://cms.gov/derechos-facturas-medicas
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0341.html
- https://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0165.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0083.html
- https://www.cms.gov/medical-bill-rights
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1160.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0971.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1298.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1134.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/P1462.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0113.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0384.html

---

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

**Bug ID:** `VS-c0aac923`  
**Pattern ID:** `VS-8806389c`  
**URL:** http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-07-08.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:** 3 instances; 3 of 4664 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W38 (14 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 3 of 4664 scanned pages (3 instances).

### Steps to reproduce
1. Open http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-07-08.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/2015-Fact-sheets-items/2015-07-08.html
- https://www.cms.gov/about-cms/contact/newsroom
- http://www.cms.gov/apps/media?page=2

### 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/2015-Fact-sheets-items/2015-07-08.html
- https://www.cms.gov/about-cms/contact/newsroom
- http://www.cms.gov/apps/media?page=2

---

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

**Bug ID:** `VS-aeff9e5d`  
**Pattern ID:** `VS-0066c67d`  
**URL:** http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.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:** 298 instances; 298 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

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

### Description
Headings should not be empty. Detected by axe-core rule empty-heading on 298 of 4664 scanned pages (298 instances).

### Steps to reproduce
1. Open http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.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://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0210.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0202.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0060.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P1036.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0238.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0027.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0240.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0131.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0271.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0263.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0096.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2161.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0211.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0099.html

…and more — 298 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://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0093.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0242.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0091.html

---

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

**Bug ID:** `VS-3b0f2d77`  
**Pattern ID:** `VS-d69fc059`  
**URL:** http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36868&lcdStatus=all&sortBy=title&ver=20  
**XPath / selector:** `tbody > tr > th`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `empty-table-header` ([reference](https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 45 instances; 20 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### HTML snippet
```html
<th>&nbsp;</th>
```

### Description
Table header text should not be empty. Detected by axe-core rule empty-table-header on 20 of 4664 scanned pages (45 instances).

### Steps to reproduce
1. Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36868&lcdStatus=all&sortBy=title&ver=20.
2. Locate the element: tbody > tr > th
3. Confirm the axe-core finding for rule empty-table-header.

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

### Affected pages
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36868&lcdStatus=all&sortBy=title&ver=20
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1138.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=282&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=268&proposed=Y&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36889&lcdStatus=all&sortBy=title&stateRegion=all&ver=24
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=Y&type=Closed
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1178.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=101&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=16
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=317&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36868&lcdStatus=all&sortBy=title&ver=24
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=85&proposed=N&type=Closed
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=218&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=295&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=297&type=Open
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=179&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare/quality/value-based-programs/value-based-purchasing-snf-vbp-program/spotlights-announcements
- https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=76&sortBy=meetingdate&year=all
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=321&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=77&proposed=N

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

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

### Example pages
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36868&lcdStatus=all&sortBy=title&ver=20
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1138.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=282&proposed=N&sortBy=status&status=all

---

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

**Bug ID:** `VS-a837040e`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc  
**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:** 435 instances; 435 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 435 of 4664 scanned pages (435 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r61.

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

### Affected pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc
- https://cms.gov/about-cms/work-with-us/careers/positions
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals/r12626otn
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10737cp
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- https://www.cms.gov/medicare/forms-notices/cms-forms-list
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58113&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/initiatives/health-technology-ecosystem/overview/medicare-app-library
- https://cms.gov/medicare/regulations-guidance/physician-self-referral/self-referral-disclosure-protocol-settlements
- http://www.cms.gov/apps/ama/license.asp?file=%2FResearch-Statistics-Data-and-Systems%2FStatistics-Trends-and-Reports%2FMedicareMedicaidStatSupp%2FDownloads%2F2005_Table70.pdf
- http://cms.gov/medicare/medicare-fee-for-service-payment/physicianfeedbackprogram/2012-supplemental-qrur
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10269cp
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2016-transmittals?items_per_page=25&order=field_dyna_subject_formatted&sort=desc
- https://www.cms.gov/medicare/coverage/determination-process/local
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2013-transmittals-items/r1174otn
- https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35172&lcdStatus=all&sortBy=title&ver=72
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53026&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=62
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2017-transmittals-items/r1850otn
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals/r13198cp
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59828&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11

…and more — 435 pages total ([download CSV](csv/alfa__sia-r61.csv)).

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

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

### Example pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc
- https://cms.gov/about-cms/work-with-us/careers/positions
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-60b9a0b0`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2  
**XPath / selector:** `<h3 id="h3GeneralInformationHeader" class="document-view-section-header">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 165 instances; 164 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 164 of 4664 scanned pages (165 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2.
2. Locate the element: <h3 id="h3GeneralInformationHeader" class="document-view-section-header">
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58113&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://www.cms.gov/apps/ama/license.asp?file=%2FResearch-Statistics-Data-and-Systems%2FStatistics-Trends-and-Reports%2FMedicareMedicaidStatSupp%2FDownloads%2F2005_Table70.pdf
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53026&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=62
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59828&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57891&articleStatus=all&bc=3&sortBy=title&ver=32
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37293&lcdStatus=all&sortBy=title&ver=28
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37313&ver=28
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38792&lcdStatus=all&sortBy=title&ver=6
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53446&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=6
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleId=60357&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39434&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=36139&sortBy=relevance&ver=30
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36544&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37863&lcdStatus=all&sortBy=title&stateRegion=all
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38918&lcdStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare/payment/covid-19-vaccine-toolkit/medicare-covid-19-vaccine-shot-payment
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53605&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=21
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39933&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58770&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=5
- https://www.cms.gov/nosurprises

…and more — 164 pages total ([download CSV](csv/alfa__sia-r53.csv)).

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

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54790&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=2
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8

---

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

**Bug ID:** `VS-9de3455b`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&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:** 163 instances; 163 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 163 of 4664 scanned pages (163 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&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://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc
- https://cms.gov/about-cms/work-with-us/careers/positions
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals/r12626otn
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10737cp
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities
- https://www.cms.gov/medicare/forms-notices/cms-forms-list
- http://cms.gov/initiatives/health-technology-ecosystem/overview/medicare-app-library
- http://www.cms.gov/apps/ama/license.asp?file=%2FResearch-Statistics-Data-and-Systems%2FStatistics-Trends-and-Reports%2FMedicareMedicaidStatSupp%2FDownloads%2F2005_Table70.pdf
- http://cms.gov/medicare/medicare-fee-for-service-payment/physicianfeedbackprogram/2012-supplemental-qrur
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10269cp
- https://www.cms.gov/medicare/coverage/determination-process/local
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2013-transmittals-items/r1174otn
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2017-transmittals-items/r1850otn
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals/r13198cp
- http://www.cms.gov/medicare/quality/value-based-programs/other
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_implementation_date&page=1&sort=desc
- http://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r11730otn
- https://www.cms.gov/about-cms/who-we-are/leadership/office-healthcare-experience-interoperability
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2026-transmittals?page=5
- https://www.cms.gov/medical-bill-rights/help/submit-a-complaint/get-started
- https://www.cms.gov/newsroom/fact-sheets/2025-medicare-advantage-part-d-rate-announcement
- https://www.cms.gov/about-cms/contact/directory/milwaukee-health-services-system-llc/1559166
- https://cms.gov/medicare/payment/fee-schedules/clinical-laboratory-fee-schedule-clfs/files/25clabq2
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2018-transmittals-items/r2192otn
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals/r12861fm

…and more — 163 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://cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=0&sort=asc
- https://cms.gov/about-cms/work-with-us/careers/positions
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2024-transmittals/r12626otn

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-aba61594`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html  
**XPath / selector:** `<h1>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r78` ([reference](https://alfa.siteimprove.com/rules/sia-r78))  
**Severity:** Moderate  
**Frequency:** 149 instances; 124 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 124 of 4664 scanned pages (149 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html.
2. Locate the element: <h1>
3. Confirm the Siteimprove Alfa finding for rule sia-r78.

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

### Affected pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57474&articleStatus=all&bc=3&sortBy=title&ver=33
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57948&bc=13&contractorName=all&contractorNumber=all&sortBy=updated&updatePeriod=1204&ver=26
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- http://cms.gov/initiatives/health-technology-ecosystem/overview/medicare-app-library
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0135.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0127.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53026&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=62
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59828&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57891&articleStatus=all&bc=3&sortBy=title&ver=32
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0102.html
- http://www.cms.gov/about-cms/what-we-do/emergency-response/past-emergencies/cyber-attacks
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0043.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0357.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1785.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0076.html
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=37863&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=53605&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=21
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39933&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0309.html
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56232&articleStatus=all&bc=3&sortBy=title&ver=34
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58183&articleStatus=all&bc=3&sortBy=title&ver=14

…and more — 124 pages total ([download CSV](csv/alfa__sia-r78.csv)).

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

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

### Example pages
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0340.html
- https://www.cms.gov/about-cms/grants-cooperative-agreements/currentnts-funding-opportunities
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59874&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8

---

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

**Bug ID:** `VS-365bc046`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html  
**XPath / selector:** `img`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 2094 instances; 57 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

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

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 57 of 4664 scanned pages (2094 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html.
2. Locate the element: img
3. Confirm the deprecated-html finding for rule presentational-attr.

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

### Affected pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0238.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0264.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0217.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38371&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56157&articleStatus=all&bc=3&sortBy=title&ver=19
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0309.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0038.html
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=40&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36393&lcdStatus=all&sortBy=title&stateRegion=all&ver=37
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56453&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=304&proposed=N
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0088.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1855.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=268&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=309&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38339&lcdStatus=all&sortBy=title&stateRegion=all&ver=16
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0123.html
- http://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0036.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33803&lcdStatus=all&sortBy=title&stateRegion=all&ver=61
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0204.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38394&lcdStatus=all&sortBy=title&ver=11
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0232.html

…and more — 57 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://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0369.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0331.html
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1212.html

---

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

**Bug ID:** `VS-77d57b1b`  
**Pattern ID:** `VS-f2542d87`  
**URL:** https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=Y&type=Closed  
**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 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (15 weeks)

### Description
Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 3 of 4664 scanned pages (3 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&NCAId=279&proposed=Y&type=Closed.
2. Locate the element: <pre>
3. Confirm the Siteimprove Alfa finding for rule sia-r79.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?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=239&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=173&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://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=239&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=173&proposed=N

---

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

**Bug ID:** `VS-07a0c8e4`  
**Pattern ID:** `VS-91d2294a`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=304&proposed=N  
**XPath / selector:** `font`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `font-element`  
**Severity:** Moderate  
**Frequency:** 27 instances; 3 of 4664 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W38 (13 weeks)

### HTML snippet
```html
<font color="FF0000">(Rev.)</font>
```

### Description
Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 3 of 4664 scanned pages (27 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=304&proposed=N.
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/ncacal-decision-memo.aspx?NCAId=304&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=268&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=309&proposed=N&sortBy=status&status=all

### 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/ncacal-decision-memo.aspx?NCAId=304&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=268&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=309&proposed=N&sortBy=status&status=all

---

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

**Bug ID:** `VS-02d19589`  
**Pattern ID:** `VS-3d033717`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=282&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:** 2 instances; 2 of 4664 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W38 (13 weeks)

### Description
No obsolete or deprecated elements are used. Detected by Siteimprove Alfa rule sia-r70 on 2 of 4664 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=282&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=282&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52841&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4

### 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=282&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52841&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4

---

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

**Bug ID:** `VS-1bc326ac`  
**Pattern ID:** `VS-7fbb8b20`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0617.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:** 1 instances; 1 of 4664 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W38 (12 weeks)

### Description
Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 1 of 4664 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0617.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/P0617.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

---

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

**Bug ID:** `VS-53910536`  
**Pattern ID:** `VS-e43903a1`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0617.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:** 2 instances; 1 of 4664 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W38 (12 weeks)

### Description
Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 1 of 4664 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0617.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/P0617.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