# Accessibility bug reports — www.cms.gov, week 2026-W39

47 issue type(s) from 4208 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-502c16a0`  
**Pattern ID:** `VS-179ad9b3`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html  
**XPath / selector:** `<a href="http://www.cms.gov/" title="CMS Home Page">`  
**WCAG SC:** 2.5.8 — Target Size (Minimum) (Level AA)  
**Rule:** Siteimprove Alfa — `sia-r113` ([reference](https://alfa.siteimprove.com/rules/sia-r113))  
**Severity:** Moderate  
**Frequency:** 252 instances; 79 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 79 of 4208 scanned pages (252 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html.
2. Locate the element: <a href="http://www.cms.gov/" title="CMS Home Page">
3. Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=343&ncdver=2&sortBy=title
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58865&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=24
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=342&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57661&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=17
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0217.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56809&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35222&ver=25
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57179&articleStatus=all&bc=3&sortBy=title&ver=20
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53531&articleStatus=all&bc=3&sortBy=title&ver=22
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54931&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=34
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0278.html
- http://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60366&ver=4
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0279.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55624&articleStatus=all&bc=3&sortBy=title&ver=33
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53359&articleStatus=all&bc=3&sortBy=title&ver=35
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58761&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=70
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59466&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57620&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38016&ver=21
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58973&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=24

…and more — 79 pages total ([download CSV](csv/alfa__sia-r113.csv)).

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

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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=343&ncdver=2&sortBy=title

---

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

**Bug ID:** `VS-eeafcb5c`  
**Pattern ID:** `VS-f7dba940`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43  
**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:** 417 instances; 182 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 182 of 4208 scanned pages (417 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43.
2. Locate the element: <a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">
3. Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39958&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=137&ncdver=1&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54554&articleStatus=all&bc=3&sortBy=title&ver=3
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=343&ncdver=2&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39017&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39230&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37750&lcdStatus=all&sortBy=title&ver=29
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33632&lcdStatus=all&sortBy=title&ver=82
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39084&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&stateRegion=all&ver=26
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=100&ncdver=1&sortBy=chapter
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38051&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36700&lcdStatus=all&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38686&lcdStatus=all&sortBy=title&ver=16
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=EAAAAAgAAAAA&DocID=150.5&kq=true&ncdid=58&ncdver=2&SearchType=Advanced
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=40143&proposedStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38310&lcdStatus=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58865&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=24
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=342&ncdver=1&sortBy=title

…and more — 182 pages total ([download CSV](csv/alfa__sia-r14.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-85cfbbc4`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.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:** 253 instances; 248 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (15 weeks)

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

### Description
Images must have alternative text. Detected by axe-core rule image-alt on 248 of 4208 scanned pages (253 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html.
2. Locate the element: img[src$="cms-site-logo.png"]
3. Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

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

### Affected pages
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0024.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0035.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0801.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0146.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0364.html
- http://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0113.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0019.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0201.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0267.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P1845.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0141.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0126.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0008.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0648.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0225.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0226.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0963.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2067.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html

…and more — 248 pages total ([download CSV](csv/axe-core__image-alt.csv)).

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

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

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

### Example pages
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0025.html

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-a3e35fc8`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.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:** 35 instances; 31 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (15 weeks)

### Description
Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 31 of 4208 scanned pages (35 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html.
2. Locate the element: <img src="cms-site-logo.png">
3. Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

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

### Affected pages
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0217.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0278.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0279.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1154.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0490.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0199.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0300.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=245&proposed=N
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0060.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0002.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0104.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1784.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1860.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0032.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0100.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0029.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0995.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0291.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0754.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0327.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0953.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1155.html

…and more — 31 pages total ([download CSV](csv/alfa__sia-r2.csv)).

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

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

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

### Example pages
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0217.html

---

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

**Bug ID:** `VS-ca4ef5d8`  
**Pattern ID:** `VS-a0bdbdf6`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37549&lcdStatus=all&sortBy=title&stateRegion=all&ver=21  
**XPath / selector:** `ul[type="disc"]`  
**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:** 933 instances; 210 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### HTML snippet
```html
<ul type="disc">
```

### Description
<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 210 of 4208 scanned pages (933 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37549&lcdStatus=all&sortBy=title&stateRegion=all&ver=21.
2. Locate the element: ul[type="disc"]
3. Confirm the axe-core finding for rule list against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37549&lcdStatus=all&sortBy=title&stateRegion=all&ver=21
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33312&lcdStatus=all&sortBy=title&ver=37
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56071&articleStatus=all&bc=3&sortBy=title&ver=23
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34084&lcdStatus=all&sortBy=title&stateRegion=all&ver=24
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38629&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55478&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33954&lcdStatus=all&sortBy=title&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54418&articleStatus=all&bc=3&sortBy=title&ver=25
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52450&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=82
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57069&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=25
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57957&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=47
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39297&lcdStatus=all&sortBy=title&ver=7
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33632&lcdStatus=all&sortBy=title&ver=82
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55479&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=40324&ver=6
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38809&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57071&ver=30
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=40143&proposedStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58321&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55659&ver=2
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=40221&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38310&lcdStatus=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33573&lcdStatus=all&sortBy=title&stateRegion=all&ver=25
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39883&lcdStatus=all&sortBy=title&ver=8

…and more — 210 pages total ([download CSV](csv/axe-core__list.csv)).

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

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37549&lcdStatus=all&sortBy=title&stateRegion=all&ver=21
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33312&lcdStatus=all&sortBy=title&ver=37

---

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

**Bug ID:** `VS-40bc737c`  
**Pattern ID:** `VS-6175596b`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=82&sortBy=meetingdate&year=all  
**XPath / selector:** `div:nth-child(4) > li:nth-child(2)`  
**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:** 147 instances; 11 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### HTML snippet
```html
<li><a href="#agenda">Agenda</a>
</li>
```

### Description
<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 11 of 4208 scanned pages (147 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=82&sortBy=meetingdate&year=all.
2. Locate the element: div:nth-child(4) > li:nth-child(2)
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/medcac-meeting.aspx?bc=15&medcacid=82&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=187&proposed=Y&sortBy=status&status=all
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=293&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=250&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?=&bc=AAAAAAAAACAA&fromTracking=Y&ncaid=321&proposed=N
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=70&sortBy=meetingdate&year=all
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=21&doctype=all&fromTracking=Y&ncaid=313&proposed=N&sortBy=updated&timeframe=30
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=309&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?NCAId=293&proposed=N
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=78&sortBy=meetingdate&year=all

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

### Suggested fix
**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/medcac-meeting.aspx?bc=15&medcacid=82&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=187&proposed=Y&sortBy=status&status=all

---

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

**Bug ID:** `VS-9c5c3291`  
**Pattern ID:** `VS-07ba3b17`  
**URL:** https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=5&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:** 3 instances; 3 of 4208 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W39 (15 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 3 of 4208 scanned pages (3 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=5&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://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=5&sort=desc
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_release_date&page=3&sort=asc
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=11&sort=asc

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

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

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

### Example pages
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=5&sort=desc
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_release_date&page=3&sort=asc
- https://cms.gov/medicare/regulations-guidance/transmittals/2020-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=11&sort=asc

---

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

**Bug ID:** `VS-0f8960e1`  
**Pattern ID:** `VS-d6097011`  
**URL:** https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title  
**XPath / selector:** `<tfoot>`  
**WCAG SC:** 1.3.1 — Info and Relationships (Level A)  
**Rule:** Siteimprove Alfa — `sia-r68` ([reference](https://alfa.siteimprove.com/rules/sia-r68))  
**Severity:** Moderate  
**Frequency:** 114 instances; 45 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 45 of 4208 scanned pages (114 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title.
2. Locate the element: <tfoot>
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33632&lcdStatus=all&sortBy=title&ver=82
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38051&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=36538&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39270&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33559&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=208&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=36707&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39044&lcdStatus=all&sortBy=title&ver=15
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=34045&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33642&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=213&sortBy=status&status=all
- http://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60366&ver=4
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33630&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=40052&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36236&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33736&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=38705&lcdStatus=all&sortBy=title
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35001&lcdStatus=all&sortBy=title&ver=12
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=40242&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=36700&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=278
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=32553&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34892&lcdStatus=all&sortBy=title&stateRegion=all&ver=123
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-proposed-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=40299&proposedStatus=all&sortBy=title

…and more — 45 pages total ([download CSV](csv/alfa__sia-r68.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33632&lcdStatus=all&sortBy=title&ver=82
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38051&lcdStatus=all&sortBy=title

---

## Element has required owned roles (WCAG 1.3.1)

**Bug ID:** `VS-2305b4b8`  
**Pattern ID:** `VS-3c632d31`  
**URL:** http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.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:** 30 instances; 30 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 30 of 4208 scanned pages (30 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html.
2. Locate the element: <h1>
3. Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0217.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0278.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0279.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1154.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0490.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0199.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0300.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0060.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0002.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0104.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1784.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1860.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0032.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0100.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0029.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0995.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0291.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0754.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0327.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0953.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1155.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0306.html

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

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

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

### Example pages
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0217.html

---

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

**Bug ID:** `VS-f9861eb9`  
**Pattern ID:** `VS-4408605e`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&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:** 36 instances; 20 of 4208 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W39 (15 weeks)

### Description
Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 20 of 4208 scanned pages (36 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&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=57198&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58865&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=24
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56948&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56809&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33774&lcdStatus=all&sortBy=title&ver=13
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57179&articleStatus=all&bc=3&sortBy=title&ver=20
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54931&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=34
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53359&articleStatus=all&bc=3&sortBy=title&ver=35
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57130&ver=44
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59608&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=32
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56493&ver=13
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57622&ver=17
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57361&ver=43
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57162&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=13
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53127&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=193
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57330&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=15
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53001&articleStatus=all&bc=3&sortBy=title&ver=42
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57864&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=32
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57498&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=11

### 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=57198&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58865&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=24

---

## Table cell has header (WCAG 1.3.1)

**Bug ID:** `VS-4f01ca09`  
**Pattern ID:** `VS-3f067795`  
**URL:** https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html  
**XPath / selector:** `<td colspan="4" class="itl">`  
**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:** 27 instances; 5 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 5 of 4208 scanned pages (27 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html.
2. Locate the element: <td colspan="4" class="itl">
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/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=55&sortBy=meetingdate&year=all
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36889&lcdStatus=all&sortBy=title&ver=25
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=197&proposed=N
- http://cms.gov/icd10m/FY2027-fr-v44-fullcode-cms/fullcode_cms/P1716.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-r77

### Example pages
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=55&sortBy=meetingdate&year=all
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36889&lcdStatus=all&sortBy=title&ver=25

---

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

**Bug ID:** `VS-77e8f2db`  
**Pattern ID:** `VS-8ade3360`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39614&lcdStatus=all&sortBy=title&ver=5  
**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:** 844 instances; 366 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### HTML snippet
```html
<a href="https://localcoverage.cms.gov/mcd_archive/view/lcd.aspx?lcdInfo=39613:3" target="_blank" class="log-click system-link" data-page-action="Clicked the Source Proposed LCD link">DL39614</a>
```

### Description
Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 366 of 4208 scanned pages (844 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39614&lcdStatus=all&sortBy=title&ver=5.
2. Locate the element: #lblProposedLcd > .system-link.log-click[target="_blank"]
3. Confirm the axe-core finding for rule link-in-text-block against WCAG 1.4.1 Use of Color.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39614&lcdStatus=all&sortBy=title&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37549&lcdStatus=all&sortBy=title&stateRegion=all&ver=21
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39068&lcdStatus=all&sortBy=title&stateRegion=all&ver=8
- http://www.cms.gov/medicare-coverage-database/details/nca-details.aspx?NCAId=203
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39958&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37598&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39911&lcdStatus=all&sortBy=title&ver=10
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38629&lcdStatus=all&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=55478&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36267&lcdStatus=all&sortBy=title&ver=40
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35755&lcdStatus=all&sortBy=title&ver=35
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39017&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38278&lcdStatus=all&sortBy=title&ver=35
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38528&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39230&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=40402&proposedStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=35125&lcdStatus=all&sortBy=title&stateRegion=all&ver=76
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=40179&ver=5
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39297&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38647&lcdStatus=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38584&lcdStatus=all&sortBy=title&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37750&lcdStatus=all&sortBy=title&ver=29

…and more — 366 pages total ([download CSV](csv/axe-core__link-in-text-block.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39614&lcdStatus=all&sortBy=title&ver=5
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37549&lcdStatus=all&sortBy=title&stateRegion=all&ver=21
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43

---

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

**Bug ID:** `VS-d86541b0`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43  
**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 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (15 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 6 of 4208 scanned pages (12 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43.
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=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&stateRegion=all&ver=26
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58438&articleStatus=all&bc=3&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37015&lcdStatus=all&sortBy=title&stateRegion=all&ver=25
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56793&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=29
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33398&ver=32

### 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=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&stateRegion=all&ver=26
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58438&articleStatus=all&bc=3&sortBy=title&ver=8

---

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

**Bug ID:** `VS-edc8f321`  
**Pattern ID:** `VS-c613c153`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=303&proposed=Y  
**XPath / selector:** `pre`  
**WCAG SC:** 2.1.1 — Keyboard (Level A)  
**Rule:** axe-core — `scrollable-region-focusable` ([reference](https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 2 instances; 2 of 4208 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W39 (11 weeks)

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

### Description
Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 2 of 4208 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=303&proposed=Y.
2. Locate the element: pre
3. Confirm the axe-core finding for rule scrollable-region-focusable against WCAG 2.1.1 Keyboard.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=303&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=206&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:** Make scrollable regions keyboard-focusable (tabindex="0") so keyboard users can scroll them.

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=303&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=206&proposed=Y

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-408cbf08`  
**Pattern ID:** `VS-e9fe47ac`  
**URL:** https://www.cms.gov/newsroom/press-releases/new-participants-join-several-cms-alternative-payment-models  
**XPath / selector:** `a[data-once="linkMatch"]:nth-child(3)`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** axe-core — `link-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 4 instances; 3 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### HTML snippet
```html
<a href="https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprog/Downloads/2017-MSP-Fact-Sheet.pdf" data-once="linkMatch"><br></a>
```

### Description
Links must have discernible text. Detected by axe-core rule link-name on 3 of 4208 scanned pages (4 instances).

### Steps to reproduce
1. Open https://www.cms.gov/newsroom/press-releases/new-participants-join-several-cms-alternative-payment-models.
2. Locate the element: a[data-once="linkMatch"]:nth-child(3)
3. Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

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

### Affected pages
- https://www.cms.gov/newsroom/press-releases/new-participants-join-several-cms-alternative-payment-models
- https://www.cms.gov/newsroom/fact-sheets/september-30-2015-effectuated-enrollment-snapshot
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments

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

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

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

### Example pages
- https://www.cms.gov/newsroom/press-releases/new-participants-join-several-cms-alternative-payment-models
- https://www.cms.gov/newsroom/fact-sheets/september-30-2015-effectuated-enrollment-snapshot
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments

---

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

**Bug ID:** `VS-f068b80b`  
**Pattern ID:** `VS-c126b6a6`  
**URL:** https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.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:** 256 instances; 256 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

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

### Description
<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 256 of 4208 scanned pages (256 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html.
2. Locate the element: html
3. Confirm the axe-core finding for rule html-has-lang against WCAG 3.1.1 Language of Page.

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

### Affected pages
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0024.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0035.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0801.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0146.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0364.html
- http://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0113.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0019.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0201.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0267.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P1845.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0141.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0126.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0008.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0648.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0225.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0226.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0963.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2067.html

…and more — 256 pages total ([download CSV](csv/axe-core__html-has-lang.csv)).

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

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

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

### Example pages
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html

---

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

**Bug ID:** `VS-b252cb89`  
**Pattern ID:** `VS-7a0e5645`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.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:** 32 instances; 32 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 32 of 4208 scanned pages (32 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html.
2. Locate the element: <html>
3. Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page.

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0217.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0278.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0279.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1154.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0490.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0199.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0300.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0060.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0002.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0104.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1784.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1860.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0032.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0100.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0279.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0029.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0995.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0291.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0754.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0327.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0953.html

…and more — 32 pages total ([download CSV](csv/alfa__sia-r4.csv)).

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

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

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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html

---

## Form elements must have labels (WCAG 4.1.2)

**Bug ID:** `VS-7d1c9620`  
**Pattern ID:** `VS-fafffee0`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.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:** 11 instances; 11 of 4208 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W39 (14 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 11 of 4208 scanned pages (11 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.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/P1071.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0588.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1308.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1318.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1139.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0279.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0094.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1309.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0760.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1566.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0326.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/P1071.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0588.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1308.html

---

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

**Bug ID:** `VS-a7bceebd`  
**Pattern ID:** `VS-be8d563e`  
**URL:** http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html  
**XPath / selector:** `.watermark`  
**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:** 474 instances; 43 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### HTML snippet
```html
<p class="watermark">DRAFT</p>
```

### Description
Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 43 of 4208 scanned pages (474 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html.
2. Locate the element: .watermark
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
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=303&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=187&proposed=Y&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=268&proposed=Y
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=293&proposed=N
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36704&lcdStatus=all&sortBy=title&ver=23
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0150.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36704&lcdStatus=all&sortBy=title&ver=23
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0276.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0228.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34425&lcdStatus=all&sortBy=title&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=33370&proposedStatus=all&sortBy=title&ver=55
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0013.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52503&ver=23
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=190&ncdver=4&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33611&lcdStatus=all&sortBy=title&ver=25
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0362.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0308.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0125.html
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=21&doctype=all&fromTracking=Y&ncaid=313&proposed=N&sortBy=updated&timeframe=30
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33393&lcdStatus=all&sortBy=title&ver=9
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0199.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36704&lcdStatus=all&sortBy=title&ver=22
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0032.html

…and more — 43 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
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=303&proposed=Y

---

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

**Bug ID:** `VS-e1384346`  
**Pattern ID:** `VS-f7e99f4b`  
**URL:** http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36704&lcdStatus=all&sortBy=title&ver=23  
**XPath / selector:** `text: "Clinicopathologic Findings"`  
**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:** 44 instances; 5 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 5 of 4208 scanned pages (44 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36704&lcdStatus=all&sortBy=title&ver=23.
2. Locate the element: text: "Clinicopathologic Findings"
3. Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum).

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

### Affected pages
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36704&lcdStatus=all&sortBy=title&ver=23
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=33370&proposedStatus=all&sortBy=title&ver=55
- https://cms.gov/priorities/innovation/innovation-models/bpci-advanced
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52492&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37921&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
**How to fix:** Increase text contrast to meet WCAG AA (4.5:1, or 3:1 for large text).

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

### Example pages
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36704&lcdStatus=all&sortBy=title&ver=23
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=33370&proposedStatus=all&sortBy=title&ver=55
- https://cms.gov/priorities/innovation/innovation-models/bpci-advanced

---

## 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 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 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 4208 scanned pages (1 instances).

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

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

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

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

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

---

## Text has enhanced contrast (WCAG 1.4.6)

**Bug ID:** `VS-d4d8ae84`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43  
**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:** 1114 instances; 182 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 182 of 4208 scanned pages (1114 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43.
2. Locate the element: text: "Here's how you know"
3. Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39958&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=137&ncdver=1&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54554&articleStatus=all&bc=3&sortBy=title&ver=3
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=343&ncdver=2&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39017&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39230&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37750&lcdStatus=all&sortBy=title&ver=29
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33632&lcdStatus=all&sortBy=title&ver=82
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39084&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&stateRegion=all&ver=26
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=100&ncdver=1&sortBy=chapter
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38051&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36700&lcdStatus=all&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38686&lcdStatus=all&sortBy=title&ver=16
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=EAAAAAgAAAAA&DocID=150.5&kq=true&ncdid=58&ncdver=2&SearchType=Advanced
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=40143&proposedStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38310&lcdStatus=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58865&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=24
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=342&ncdver=1&sortBy=title

…and more — 182 pages total ([download CSV](csv/alfa__sia-r66.csv)).

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

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100

---

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

**Bug ID:** `VS-12ecb7bd`  
**Pattern ID:** `VS-2208081b`  
**URL:** https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip  
**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:** 3880 instances; 367 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 367 of 4208 scanned pages (3880 instances).

### Steps to reproduce
1. Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
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://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100
- https://www.cms.gov/contacts/virginia-treatment-center-llc/general-beneficiary-contact/1558961
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2015-transmittals-items/r1583otn
- https://cms.gov/newsroom/press-releases/medicare-cover-aprepitant-emendr-part-three-drug-regimen-chemotherapy-induced-nausea-and-vomiting
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39958&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/newsroom/press-releases/medicare-advantage-enrollment-all-time-high-premiums-remain-affordable
- https://www.cms.gov/about-cms/what-we-do/emergency-response/current-emergencies
- https://www.cms.gov/help-support
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26
- http://www.cms.gov/medicare/payment/prospective-payment-systems/home-health/reports
- https://www.cms.gov/contacts?combinedregionstate=region-All&field_switch=org&order=title&page=13&sort=desc
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=137&ncdver=1&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54554&articleStatus=all&bc=3&sortBy=title&ver=3
- https://www.cms.gov/medicare/coverage/determination-process/local
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- https://www.cms.gov/about-cms/who-we-are/leadership/office-hearings-inquiries
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=343&ncdver=2&sortBy=title
- http://cms.gov/medicare/regulations-guidance/transmittals/2014-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=8&sort=asc
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39017&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39230&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37750&lcdStatus=all&sortBy=title&ver=29

…and more — 367 pages total ([download CSV](csv/alfa__sia-r73.csv)).

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

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

### Example pages
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12

---

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

**Bug ID:** `VS-f6893600`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43  
**XPath / selector:** `<p class="card-text">`  
**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:** 13011 instances; 181 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 181 of 4208 scanned pages (13011 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43.
2. Locate the element: <p class="card-text">
3. Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39958&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=137&ncdver=1&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54554&articleStatus=all&bc=3&sortBy=title&ver=3
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=343&ncdver=2&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39017&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39230&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37750&lcdStatus=all&sortBy=title&ver=29
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33632&lcdStatus=all&sortBy=title&ver=82
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39084&lcdStatus=all&sortBy=title&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&stateRegion=all&ver=26
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=190&labOnly=labonlyncd&ncdid=100&ncdver=1&sortBy=chapter
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38051&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36700&lcdStatus=all&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38686&lcdStatus=all&sortBy=title&ver=16
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=EAAAAAgAAAAA&DocID=150.5&kq=true&ncdid=58&ncdver=2&SearchType=Advanced
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=40143&proposedStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38310&lcdStatus=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58865&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=24
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=342&ncdver=1&sortBy=title

…and more — 181 pages total ([download CSV](csv/alfa__sia-r74.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100

---

## Scrollable element is keyboard accessible (WCAG 1.4.8)

**Bug ID:** `VS-514cbc23`  
**Pattern ID:** `VS-388b5438`  
**URL:** https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12  
**XPath / selector:** `<p style="line-height: 12.0pt;">`  
**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:** 122 instances; 8 of 4208 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W39 (15 weeks)

### Description
Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 8 of 4208 scanned pages (122 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12.
2. Locate the element: <p style="line-height: 12.0pt;">
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://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37750&lcdStatus=all&sortBy=title&ver=29
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57661&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=17
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59006&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59466&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=6
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34892&lcdStatus=all&sortBy=title&stateRegion=all&ver=123
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=40341&lcdStatus=all&sortBy=title&ver=6
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38771&lcdStatus=all&sortBy=title&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-r80

### Example pages
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37750&lcdStatus=all&sortBy=title&ver=29
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57661&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=17

---

## iframe element is not empty (WCAG 1.4.8)

**Bug ID:** `VS-b50588cb`  
**Pattern ID:** `VS-48291402`  
**URL:** http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59006&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4  
**XPath / selector:** `<p style="text-align: justify; line-height: 13.4pt;">`  
**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:** 44 instances; 8 of 4208 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W39 (15 weeks)

### Description
iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 8 of 4208 scanned pages (44 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59006&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4.
2. Locate the element: <p style="text-align: justify; line-height: 13.4pt;">
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=59006&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58761&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=70
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33444&lcdStatus=all&sortBy=title&ver=42
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58618&articleStatus=all&bc=3&sortBy=title&ver=3
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=58454&ver=50
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58967&articleStatus=all&bc=3&sortBy=title&ver=4
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=40350&proposedStatus=all&sortBy=title&ver=15
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39832&lcdStatus=all&sortBy=title&stateRegion=all&ver=15

### 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=59006&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=4
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58761&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=70
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33444&lcdStatus=all&sortBy=title&ver=42

---

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

**Bug ID:** `VS-836f94b9`  
**Pattern ID:** `VS-cb53cc4d`  
**URL:** https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip  
**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:** 12202 instances; 377 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 377 of 4208 scanned pages (12202 instances).

### Steps to reproduce
1. Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
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://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100
- https://www.cms.gov/contacts/virginia-treatment-center-llc/general-beneficiary-contact/1558961
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2015-transmittals-items/r1583otn
- https://cms.gov/newsroom/press-releases/medicare-cover-aprepitant-emendr-part-three-drug-regimen-chemotherapy-induced-nausea-and-vomiting
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39958&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/newsroom/press-releases/medicare-advantage-enrollment-all-time-high-premiums-remain-affordable
- https://www.cms.gov/about-cms/what-we-do/emergency-response/current-emergencies
- https://www.cms.gov/help-support
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26
- http://www.cms.gov/medicare/payment/prospective-payment-systems/home-health/reports
- https://www.cms.gov/contacts?combinedregionstate=region-All&field_switch=org&order=title&page=13&sort=desc
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=137&ncdver=1&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54554&articleStatus=all&bc=3&sortBy=title&ver=3
- https://www.cms.gov/medicare/coverage/determination-process/local
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- https://www.cms.gov/about-cms/who-we-are/leadership/office-hearings-inquiries
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=343&ncdver=2&sortBy=title
- http://cms.gov/medicare/regulations-guidance/transmittals/2014-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=8&sort=asc
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39017&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39230&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title

…and more — 377 pages total ([download CSV](csv/alfa__sia-r111.csv)).

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

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

### Example pages
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12

---

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

**Bug ID:** `VS-25377ac5`  
**Pattern ID:** `VS-bd13f00a`  
**URL:** http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html  
**XPath / selector:** `td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0220.html"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `accesskeys` ([reference](https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 261 instances; 87 of 4208 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W39 (13 weeks)

### HTML snippet
```html
<a accesskey="p" id="prev_page" href="P0220.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 87 of 4208 scanned pages (261 instances).

### Steps to reproduce
1. Open http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html.
2. Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0220.html"]
3. Confirm the axe-core finding for rule accesskeys.

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

### Affected pages
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0201.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P1845.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0008.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0963.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2067.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1710.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0360.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0321.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2064.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1136.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1725.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0150.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0141.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0276.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0228.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0527.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0021.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0221.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2143.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0712.html

…and more — 87 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
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0201.html

---

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

**Bug ID:** `VS-a9b7d64e`  
**Pattern ID:** `VS-d25f622d`  
**URL:** https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip  
**XPath / selector:** `.content > h3:nth-child(2)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 268 instances; 265 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### HTML snippet
```html
<h3>End User Point and Click Agreement:</h3>
```

### Description
Heading levels should only increase by one. Detected by axe-core rule heading-order on 265 of 4208 scanned pages (268 instances).

### Steps to reproduce
1. Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
2. Locate the element: .content > h3:nth-child(2)
3. Confirm the axe-core finding for rule heading-order.

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

### Affected pages
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39268&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&calid=254&ncacaldoctype=all&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare/physician-fee-schedule/search/overview
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=34914&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33267&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=303&proposed=Y
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=36866&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=187&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title
- https://cms.gov/data-research/monitoring-programs/improper-payment-measurement-programs/comprehensive-error-rate-testing-cert/background
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33796&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38968&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38051&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=34196&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33967&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Payment%2Fphysicianfeesched%2Fdownloads%2FGPCI10V2.zip
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=34434&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33261&lcdStatus=all&sortBy=title
- http://www.cms.gov/apps/aha/license.asp?file=%2Ffiles%2Fzip%2Fi%2Foce-mf-software-package-v240r1.zip
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38284&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=69&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=37738&lcdStatus=all&sortBy=title
- http://www.cms.gov/medicare/quality/value-based-programs/other/home-health-value-based-purchasing-hhvbp-model

…and more — 265 pages total ([download CSV](csv/axe-core__heading-order.csv)).

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

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

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

### Example pages
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39268&lcdStatus=all&sortBy=title&stateRegion=all

---

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

**Bug ID:** `VS-0e54c170`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.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:** 256 instances; 256 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

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

### Description
Document should have one main landmark. Detected by axe-core rule landmark-one-main on 256 of 4208 scanned pages (256 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html.
2. Locate the element: html
3. Confirm the axe-core finding for rule landmark-one-main.

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

### Affected pages
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0024.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0035.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0801.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0146.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0364.html
- http://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0113.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0019.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0201.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0267.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P1845.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0141.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0126.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0008.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0648.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0225.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0226.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0963.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2067.html

…and more — 256 pages total ([download CSV](csv/axe-core__landmark-one-main.csv)).

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

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

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

### Example pages
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html

---

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

**Bug ID:** `VS-ec0c6c71`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.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:** 4294 instances; 256 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 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 v42.0 Definitions Manual</h1><h1></h1></td>
		<td></td>
		<td></td>
		<td></td>
	</tr>
```

### Description
All page content should be contained by landmarks. Detected by axe-core rule region on 256 of 4208 scanned pages (4294 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.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
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0024.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0035.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0801.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0146.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0364.html
- http://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0113.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0019.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0201.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0267.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P1845.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0141.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0126.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0008.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0648.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0225.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0226.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0963.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2067.html

…and more — 256 pages total ([download CSV](csv/axe-core__region.csv)).

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

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

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

### Example pages
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html

---

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

**Bug ID:** `VS-ebeb81f2`  
**Pattern ID:** `VS-0ba8ce9d`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html  
**XPath / selector:** `th[scope="colwidth=10"]`  
**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:** 692 instances; 38 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### HTML snippet
```html
<th scope="colwidth=10">&nbsp;</th>
```

### Description
scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 38 of 4208 scanned pages (692 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html.
2. Locate the element: th[scope="colwidth=10"]
3. Confirm the axe-core finding for rule scope-attr-valid.

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

### Affected pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=8
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=187&proposed=Y&sortBy=status&status=all
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0377.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=69&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=268&proposed=Y
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1136.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromdb=true&NCAId=77&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=250&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=237&proposed=Y&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=55&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=190&ncdver=4&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38571&lcdStatus=all&sortBy=title&stateRegion=all&ver=8
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=AiAAAAAAAAAA&ncaid=261&proposed=Y&type=Closed
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=331&ncdver=1
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=87&proposed=N
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1146.html
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=262
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1154.html
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=14&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=260&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=34&proposed=N&sortBy=status&status=all
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=64&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=207&proposed=Y

…and more — 38 pages total ([download CSV](csv/axe-core__scope-attr-valid.csv)).

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

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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=8
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=187&proposed=Y&sortBy=status&status=all

---

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

**Bug ID:** `VS-5705c648`  
**Pattern ID:** `VS-fa44f293`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.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:** 17 instances; 17 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

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

### Description
Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 17 of 4208 scanned pages (17 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.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/P1071.html
- https://www.cms.gov/medicaid-chip/community-engagement-support/eligibility-made-easy
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0588.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/P1308.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1318.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1139.html
- https://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/medical-bill-rights
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0279.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0094.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1309.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0760.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1566.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0326.html
- http://cms.gov/derechos-facturas-medicas/ayuda/plan

### 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/P1071.html
- https://www.cms.gov/medicaid-chip/community-engagement-support/eligibility-made-easy
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0588.html

---

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

**Bug ID:** `VS-46fc585c`  
**Pattern ID:** `VS-8806389c`  
**URL:** https://www.cms.gov/about-cms/contact/newsroom  
**XPath / selector:** `.views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 2 instances; 2 of 4208 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W39 (15 weeks)

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

### Description
Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 2 of 4208 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/about-cms/contact/newsroom.
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
- https://www.cms.gov/about-cms/contact/newsroom
- http://www.cms.gov/apps/media/press/release.asp?Counter=3888

### 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
- https://www.cms.gov/about-cms/contact/newsroom
- http://www.cms.gov/apps/media/press/release.asp?Counter=3888

---

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

**Bug ID:** `VS-309f8928`  
**Pattern ID:** `VS-30db094d`  
**URL:** http://www.cms.gov/data-research/statistics-trends-reports/next-generation-aco-model-ngaco-public-use-files  
**XPath / selector:** `.Header`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-banner-is-top-level` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-banner-is-top-level?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (11 weeks)

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

### Description
Banner landmark should not be contained in another landmark. Detected by axe-core rule landmark-banner-is-top-level on 1 of 4208 scanned pages (1 instances).

### Steps to reproduce
1. Open http://www.cms.gov/data-research/statistics-trends-reports/next-generation-aco-model-ngaco-public-use-files.
2. Locate the element: .Header
3. Confirm the axe-core finding for rule landmark-banner-is-top-level.

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

### Affected pages
- http://www.cms.gov/data-research/statistics-trends-reports/next-generation-aco-model-ngaco-public-use-files

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

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

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

---

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

**Bug ID:** `VS-4fe31561`  
**Pattern ID:** `VS-0066c67d`  
**URL:** https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.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:** 247 instances; 247 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

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

### Description
Headings should not be empty. Detected by axe-core rule empty-heading on 247 of 4208 scanned pages (247 instances).

### Steps to reproduce
1. Open https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html.
2. Locate the element: h1:nth-child(2)
3. Confirm the axe-core finding for rule empty-heading.

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

### Affected pages
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0025.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0024.html
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0035.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0801.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0219.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0146.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0364.html
- http://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0113.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0019.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0246.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0201.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0267.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P1845.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0141.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0126.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0008.html
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0648.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0225.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0226.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0963.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2067.html
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html

…and more — 247 pages total ([download CSV](csv/axe-core__empty-heading.csv)).

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

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

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

### Example pages
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0244.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0025.html

---

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

**Bug ID:** `VS-001a37bc`  
**Pattern ID:** `VS-d69fc059`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all  
**XPath / selector:** `table[width="75%"] > tbody > tr:nth-child(1) > th:nth-child(1)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `empty-table-header` ([reference](https://dequeuniversity.com/rules/axe/4.12/empty-table-header?application=axeAPI))  
**Severity:** Minor  
**Frequency:** 59 instances; 28 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

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

### Description
Table header text should not be empty. Detected by axe-core rule empty-table-header on 28 of 4208 scanned pages (59 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all.
2. Locate the element: table[width="75%"] > tbody > tr:nth-child(1) > th:nth-child(1)
3. Confirm the axe-core finding for rule empty-table-header.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=8
- http://cms.gov/medicare/quality/value-based-programs/value-based-purchasing-snf-vbp-program/spotlights-announcements
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0377.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55659&ver=2
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=268&proposed=Y
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1136.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromdb=true&NCAId=77&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=250&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?=&bc=AAAAAAAAACAA&fromTracking=Y&ncaid=321&proposed=N
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=55&sortBy=meetingdate&year=all
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=21&doctype=all&fromTracking=Y&ncaid=313&proposed=N&sortBy=updated&timeframe=30
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1146.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1154.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36868&lcdStatus=all&sortBy=title&ver=20
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36889&lcdStatus=all&sortBy=title&ver=25
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=309&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=34&proposed=N&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=207&proposed=Y
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?NCDId=281&NCDver=8
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=BEAAAAAAEAAA&fromdb=true&NCAId=170&NcaName=Lumbar+Artificial+Disc+Replacement&ver=18
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=197&proposed=N
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1155.html

…and more — 28 pages total ([download CSV](csv/axe-core__empty-table-header.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/empty-table-header?application=axeAPI

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=17&ncacaldoctype=all&ncaid=319&proposed=Y&sortBy=status&status=all
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=8

---

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

**Bug ID:** `VS-1495eb94`  
**Pattern ID:** `VS-7118fead`  
**URL:** https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip  
**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:** 346 instances; 346 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 346 of 4208 scanned pages (346 instances).

### Steps to reproduce
1. Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
3. Confirm the Siteimprove Alfa finding for rule sia-r61.

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

### Affected pages
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100
- https://www.cms.gov/contacts/virginia-treatment-center-llc/general-beneficiary-contact/1558961
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2015-transmittals-items/r1583otn
- https://cms.gov/newsroom/press-releases/medicare-cover-aprepitant-emendr-part-three-drug-regimen-chemotherapy-induced-nausea-and-vomiting
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39958&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/newsroom/press-releases/medicare-advantage-enrollment-all-time-high-premiums-remain-affordable
- https://www.cms.gov/about-cms/what-we-do/emergency-response/current-emergencies
- https://www.cms.gov/help-support
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26
- http://www.cms.gov/medicare/payment/prospective-payment-systems/home-health/reports
- https://www.cms.gov/contacts?combinedregionstate=region-All&field_switch=org&order=title&page=13&sort=desc
- https://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=137&ncdver=1&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54554&articleStatus=all&bc=3&sortBy=title&ver=3
- https://www.cms.gov/medicare/coverage/determination-process/local
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- https://www.cms.gov/about-cms/who-we-are/leadership/office-hearings-inquiries
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=343&ncdver=2&sortBy=title
- http://cms.gov/medicare/regulations-guidance/transmittals/2014-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=8&sort=asc
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39017&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39230&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37750&lcdStatus=all&sortBy=title&ver=29

…and more — 346 pages total ([download CSV](csv/alfa__sia-r61.csv)).

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

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

### Example pages
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&stateRegion=all&ver=43
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-23c72855`  
**Pattern ID:** `VS-f054f4a4`  
**URL:** https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip  
**XPath / selector:** `<h3>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 167 instances; 167 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 167 of 4208 scanned pages (167 instances).

### Steps to reproduce
1. Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
2. Locate the element: <h3>
3. Confirm the Siteimprove Alfa finding for rule sia-r53.

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

### Affected pages
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39958&lcdStatus=all&sortBy=title&stateRegion=all&ver=4
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54554&articleStatus=all&bc=3&sortBy=title&ver=3
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39017&lcdStatus=all&sortBy=title&stateRegion=all&ver=9
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39230&lcdStatus=all&sortBy=title&ver=7
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37750&lcdStatus=all&sortBy=title&ver=29
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33632&lcdStatus=all&sortBy=title&ver=82
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=39084&lcdStatus=all&sortBy=title&ver=5
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38051&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36700&lcdStatus=all&sortBy=title&ver=14
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38686&lcdStatus=all&sortBy=title&ver=16
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=9&lcdid=40143&proposedStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38310&lcdStatus=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58865&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=24
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=10&contractorName=all&contractorNumber=all&lcdid=38682&proposedStatus=all&sortBy=title&ver=10
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57661&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=17
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=36538&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39270&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/nosurprises
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36704&lcdStatus=all&sortBy=title&ver=23

…and more — 167 pages total ([download CSV](csv/alfa__sia-r53.csv)).

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

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

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

### Example pages
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35091&lcdStatus=all&sortBy=title&ver=100

---

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

**Bug ID:** `VS-8bbb1623`  
**Pattern ID:** `VS-c18be945`  
**URL:** https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip  
**XPath / selector:** `text: "Feedback"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 109 instances; 109 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 109 of 4208 scanned pages (109 instances).

### Steps to reproduce
1. Open https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip.
2. Locate the element: text: "Feedback"
3. Confirm the Siteimprove Alfa finding for rule sia-r57.

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

### Affected pages
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://cms.gov/newsroom/press-releases/medicare-cover-aprepitant-emendr-part-three-drug-regimen-chemotherapy-induced-nausea-and-vomiting
- https://www.cms.gov/about-cms/what-we-do/emergency-response/current-emergencies
- https://www.cms.gov/help-support
- http://www.cms.gov/medicare/payment/prospective-payment-systems/home-health/reports
- https://www.cms.gov/medicare/coverage/determination-process/local
- https://www.cms.gov/about-cms/who-we-are/leadership/office-hearings-inquiries
- http://cms.gov/medicare/regulations-guidance/transmittals/2014-transmittals?items_per_page=25&order=field_dyna_transmittal_number&page=8&sort=asc
- https://www.cms.gov/cms-l564-request-employment-information
- http://www.cms.gov/medicare/audits-compliance/part-c-d/part-c-and-part-d-enforcement-actions
- https://cms.gov/medicare/regulations-guidance/transmittals/2017-transmittals?items_per_page=25&order=field_dyna_revision_date&page=7&sort=desc
- https://www.cms.gov/medicare/regulations-guidance/legislation/freedom-information-act-foia-service-center/annual-reports
- https://www.cms.gov/medicare/enrollment-renewal/providers-suppliers/critical-access-hospitals-center
- https://www.cms.gov/digital-service
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r11095cp
- https://www.cms.gov/medicaid-chip/medicare-coordination/integrity-institute/reports
- https://www.cms.gov/nosurprises
- https://www.cms.gov/marketplace/states/creating-competitive-marketplace
- https://cms.gov/about-cms/contact/database?combinedregionstate=region-All&field_switch=org&order=field_organization_type&page=25&sort=asc
- https://www.cms.gov/newsroom/press-releases/cms-issues-final-inpatient-payment-rule
- https://www.cms.gov/regulations-and-guidance/guidance/transmittals/2017-transmittals-items/r1788otn
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2026-transmittals?items_per_page=25&order=field_dyna_pe_number&page=0&sort=asc
- https://www.cms.gov/about-cms/who-we-are/leadership/federal-coordinated-health-care-office
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_release_date&page=12&sort=desc
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2013-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=11&sort=desc

…and more — 109 pages total ([download CSV](csv/alfa__sia-r57.csv)).

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

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

### Example pages
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2FOctober2008ASPNOCFile.zip
- https://cms.gov/newsroom/press-releases/medicare-cover-aprepitant-emendr-part-three-drug-regimen-chemotherapy-induced-nausea-and-vomiting
- https://www.cms.gov/about-cms/what-we-do/emergency-response/current-emergencies

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-e1dec2f9`  
**Pattern ID:** `VS-2cd767ca`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26  
**XPath / selector:** `<h4>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r78` ([reference](https://alfa.siteimprove.com/rules/sia-r78))  
**Severity:** Moderate  
**Frequency:** 135 instances; 101 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 101 of 4208 scanned pages (135 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26.
2. Locate the element: <h4>
3. Confirm the Siteimprove Alfa finding for rule sia-r78.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title
- https://www.cms.gov/cms-l564-request-employment-information
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38051&lcdStatus=all&sortBy=title
- http://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0033.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1160.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58865&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=24
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57661&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=17
- https://cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0217.html
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=36538&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=39270&lcdStatus=all&sortBy=title&stateRegion=all
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33559&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56948&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56809&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=20
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33774&lcdStatus=all&sortBy=title&ver=13
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1685.html
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=36707&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57179&articleStatus=all&bc=3&sortBy=title&ver=20
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=34045&lcdStatus=all&sortBy=title&stateRegion=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53531&articleStatus=all&bc=3&sortBy=title&ver=22
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=54931&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=34
- https://cms.gov/icd10m/version39.0-fullcode-cms/fullcode_cms/P0278.html
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=33642&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=33630&lcdStatus=all&sortBy=title&stateRegion=all

…and more — 101 pages total ([download CSV](csv/alfa__sia-r78.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57198&ver=26
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53558&articleStatus=all&bc=3&sortBy=title&ver=29
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=35751&lcdStatus=all&sortBy=title

---

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

**Bug ID:** `VS-f58181dd`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=82&sortBy=meetingdate&year=all  
**XPath / selector:** `p`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 1710 instances; 40 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### HTML snippet
```html
<p class="MsoNormal" align="center" style="text-align:center"><strong><a name="agenda">Agenda</a><br>Medicare Evidence Development &amp; Coverage Advisory Committee<br>June 25, 2025<br>10:00 AM – 2:00
```

### Description
Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 40 of 4208 scanned pages (1710 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=82&sortBy=meetingdate&year=all.
2. Locate the element: p
3. Confirm the deprecated-html finding for rule presentational-attr.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=82&sortBy=meetingdate&year=all
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0289.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0017.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38065&lcdStatus=all&sortBy=title&stateRegion=all&ver=12
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P0640.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56230&articleStatus=all&bc=3&sortBy=title&ver=3
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60274&ver=4
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57478&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=40
- https://www.cms.gov/medicare-coverage-database/details/nca-view-public-comments.aspx?NCAId=291
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0256.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0435.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0279.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37905&lcdStatus=all&sortBy=title&stateRegion=all&ver=18
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=331&ncdver=1
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1139.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0160.html
- https://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P1034.html
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38178&lcdStatus=all&sortBy=title&stateRegion=all&ver=11
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0199.html
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=41&sortBy=meetingdate&year=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=60155&ver=6
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0062.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0100.html
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=38694&lcdStatus=all&sortBy=title&stateRegion=all&ver=12

…and more — 40 pages total ([download CSV](csv/deprecated-html__presentational-attr.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=82&sortBy=meetingdate&year=all
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0289.html
- http://www.cms.gov/icd10m/FY2023-version40.1-fullcode-cms/fullcode_cms/P0017.html

---

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

**Bug ID:** `VS-d33e737d`  
**Pattern ID:** `VS-f2542d87`  
**URL:** https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=262  
**XPath / selector:** `<pre>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r79` ([reference](https://alfa.siteimprove.com/rules/sia-r79))  
**Severity:** Moderate  
**Frequency:** 5 instances; 5 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (16 weeks)

### Description
Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 5 of 4208 scanned pages (5 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=262.
2. Locate the element: <pre>
3. Confirm the Siteimprove Alfa finding for rule sia-r79.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=262
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=14&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=245&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=197&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=95&proposed=N

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=262
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=14&proposed=N
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?fromTracking=Y&ncaid=245&proposed=N

---

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

**Bug ID:** `VS-ad8e9e76`  
**Pattern ID:** `VS-7fbb8b20`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.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:** 2 instances; 2 of 4208 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W39 (13 weeks)

### Description
Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 2 of 4208 scanned pages (2 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.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/P1071.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0279.html

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

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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0279.html

---

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

**Bug ID:** `VS-e38ca52c`  
**Pattern ID:** `VS-e43903a1`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.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:** 4 instances; 2 of 4208 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W39 (13 weeks)

### Description
Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 2 of 4208 scanned pages (4 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.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/P1071.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0279.html

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

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

### Example pages
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1071.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0279.html

---

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

**Bug ID:** `VS-eb7f9d61`  
**Pattern ID:** `VS-91d2294a`  
**URL:** http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=381&ncdver=1&sortBy=title  
**XPath / selector:** `font`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `font-element`  
**Severity:** Moderate  
**Frequency:** 14 instances; 2 of 4208 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W39 (14 weeks)

### HTML snippet
```html
<font color="FF0000"><strong>A.&nbsp;&nbsp;&nbsp; General</strong></font>
```

### Description
Obsolete <font> element (use CSS). Detected by deprecated-html rule font-element on 2 of 4208 scanned pages (14 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=381&ncdver=1&sortBy=title.
2. Locate the element: font
3. Confirm the deprecated-html finding for rule font-element.

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

### Affected pages
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=381&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=ACAAAAAAAgAAAA%3D%3D&ExpandComments=n&NCAId=285&proposed=Y

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

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

### Example pages
- http://cms.gov/medicare-coverage-database/view/ncd.aspx?bc=18&chapter=all&labOnly=allncd&ncdid=381&ncdver=1&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?bc=ACAAAAAAAgAAAA%3D%3D&ExpandComments=n&NCAId=285&proposed=Y

---

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

**Bug ID:** `VS-169579d2`  
**Pattern ID:** `VS-3d033717`  
**URL:** https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=62&sortBy=meetingdate&year=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:** 1 instances; 1 of 4208 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W39 (14 weeks)

### Description
No obsolete or deprecated elements are used. Detected by Siteimprove Alfa rule sia-r70 on 1 of 4208 scanned pages (1 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=62&sortBy=meetingdate&year=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://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=62&sortBy=meetingdate&year=all

### 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