www.cms.gov: Accessibility — week 2026-W40

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

Training priorities

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

SC	Criterion	Pages	Rules	Notes
1.4.8	WCAG 1.4.8	216	4
2.5.5	WCAG 2.5.5	155	1
1.4.1	Use of Color	142	2
1.3.1	Info and Relationships (semantic structure)	133	5	Component inconsistency
3.1.1	Language of Page	115	2

Next 10 actions

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

Design-system alignment (cms-ds / default). No design-system components detected in sampled findings.

Top 10 clustered component fixes for this week.
Cluster	Severity	Pages	Who it affects	How to fix	Evidence	Decision
Images must have alternative text · unattributed component Fix one place, resolve ~100 finding(s) on 100 page(s). XPath / selector: `img[src$="cms-site-logo.png"]` `<img src="cms-site-logo.png">`	Critical	100	Without vision, Limited vision, Limited cognitive, language, or learning ability	Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.	pages (CSV)	Decision Assigned to Notes
<html> element must have a lang attribute · unattributed component Fix one place, resolve ~106 finding(s) on 106 page(s). XPath / selector: `html` `<html>`	Serious	106	Without vision, Limited cognitive, language, or learning ability	Add a lang attribute to <html> (e.g. lang="en").	pages (CSV)	Decision Assigned to Notes
Form field label is visible · unattributed component Fix one place, resolve ~146 finding(s) on 146 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	146	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
Document should have one main landmark · unattributed component Fix one place, resolve ~106 finding(s) on 106 page(s). XPath / selector: `html` `<html>`	Moderate	106	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~60 finding(s) on 60 page(s). XPath / selector: `text: "Feedback"`	Moderate	60	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Headings should not be empty · unattributed component Fix one place, resolve ~100 finding(s) on 100 page(s). XPath / selector: `h1:nth-child(2)` `<h1></h1>`	Minor	100	Requires manual testing.	Remove empty headings or give them text. Don't use heading tags for spacing.	pages (CSV)	Decision Assigned to Notes
Page should contain a level-one heading · unattributed component Fix one place, resolve ~12 finding(s) on 12 page(s). XPath / selector: `html` `<html lang="en" dir="ltr" prefix="og: https://ogp.me/ns#" class=" js" style="--vw: 12.8px; --vh: 8px;">`	Moderate	12	Requires manual testing.	See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI	pages (CSV)	Decision Assigned to Notes
Form elements must have labels · unattributed component Fix one place, resolve ~6 finding(s) on 6 page(s). XPath / selector: `#q` `<input type="text" name="q" id="q" value="Search now" size="10" maxlength="50" class="srchbox" onfocus="this.value='';">`	Critical	6	Without vision, Limited vision, Limited manipulation/strength	Associate every form control with a <label> (via for/id) or an aria-label/aria-labelledby.	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~54 finding(s) on 54 page(s). XPath / selector: `<a id="aBasketManuButton" class="basket-icon log-click " title="View documents in your Basket" data-page-action="Clicked the Basket navbar link.">`	Moderate	54	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
All page content should be contained by landmarks · unattributed component Fix one place, resolve ~136 finding(s) on 69 page(s). XPath / selector: `td[width="31"]:nth-child(3)` `<td width="31"><a accesskey="p" id="prev_page" href="P0177.html"><img src="bakpg.png" alt="Previous Page [Alt-p]" height="14" width="31" vspace="0" hspace="0" align="bottom" border="0"></a></td>`	Moderate	69	Requires manual testing.	Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.	pages (CSV)	Decision Assigned to Notes

Bug reports

7 issue type(s) are shown by default out of 31 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 2 critical, 5 serious, 22 moderate, 2 minor. By WCAG category: 10 WCAG 2.0 A, 2 WCAG 2.0 AA, 1 WCAG 2.2 AA, 2 WCAG 2.x AAA, 9 Best Practice, 7 Undetermined. Ordered by severity, key-page impact, WCAG level, and prevalence. Following accessibility bug-reporting best practices. Download: Markdown · JSON (full archive) · JSON (AI diagnostic) · CSV (all findings) · Priority pages CSV · Priority pages JSON.

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

Default view shows 7 prioritized issue type(s); 24 more are available if you switch to "Show everything".

2 finding(s) marked "possible duplicate" — Alfa and axe-core both flagged the same WCAG SC on overlapping pages. If they target the same element, the axe-core report is authoritative. Filter the CSV by possible_duplicate_of to see these. Two engines flagging the same barrier reduces the chance of a false positive.

Findings needing review

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

Serious axe html-has-lang WCAG 2.0 A <html> element must have a lang attribute (WCAG 3.1.1) 106/1609 pages · 106 instances Likely template

Bug ID: VS-ad03df9f
Pattern ID: VS-c126b6a6
Combined ID: VS-ad03df9f (pattern VS-c126b6a6) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: axe-core — <html> element must have a lang attribute [html-has-lang]
Example URL: https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

<html>

Description

<html> element must have a lang attribute. Detected by axe-core rule html-has-lang on 106 of 1609 scanned pages (106 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html.
Locate the element: html
Confirm the axe-core finding for rule html-has-lang against WCAG 3.1.1 Language of Page.

Impact

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

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

Affected pages

…and more — all 106 pages (CSV).

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Critical axe image-alt WCAG 2.0 A Images must have alternative text (WCAG 1.1.1) 100/1609 pages · 100 instances Likely template

Bug ID: VS-80f5a637
Pattern ID: VS-9074b4dd
Combined ID: VS-80f5a637 (pattern VS-9074b4dd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: axe-core — Images must have alternative text [image-alt]
Example URL: https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html
XPath / selector: img[src$="cms-site-logo.png"]
History: first seen 2026-W24, last seen 2026-W40 (16 wk)

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

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

Description

Images must have alternative text. Detected by axe-core rule image-alt on 100 of 1609 scanned pages (100 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html.
Locate the element: img[src$="cms-site-logo.png"]
Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

Impact

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

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

Affected pages

…and more — all 100 pages (CSV).

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Critical axe label WCAG 2.0 A Form elements must have labels (WCAG 4.1.2) 6/1609 pages · 6 instances

Bug ID: VS-dc3e2cbb
Pattern ID: VS-fafffee0
Combined ID: VS-dc3e2cbb (pattern VS-fafffee0) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Form elements must have labels [label]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html
XPath / selector: #q
History: first seen 2026-W26, last seen 2026-W40 (15 wk)

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

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

Description

Form elements must have labels. Detected by axe-core rule label on 6 of 1609 scanned pages (6 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html.
Locate the element: #q
Confirm the axe-core finding for rule label against WCAG 4.1.2 Name, Role, Value.

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Serious axe color-contrast WCAG 2.0 AA Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3) 4/1609 pages · 74 instances Likely template

Bug ID: VS-82d289f1
Pattern ID: VS-be8d563e
Combined ID: VS-82d289f1 (pattern VS-be8d563e) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.3 Contrast (Minimum) (Level AA, WCAG 2.0)
Rule: axe-core — Elements must meet minimum color contrast ratio thresholds [color-contrast]
Example URL: https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
XPath / selector: em:nth-child(326) > font > p:nth-child(1)
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

<p>XX.XX Transcatheter Mitral Valve Repair (TMVR)  </p>

Description

Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 10 of 1609 scanned pages (186 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273.
Locate the element: em:nth-child(326) > font > p:nth-child(1)
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

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.

Drupal tip: Check your Drupal theme's base CSS. Themes like Olivero and Bartik have contrast issues in default color schemes — override failing color pairs in your subtheme's style.css.

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

Triage status Notes

Serious axe link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 2/1609 pages · 4 instances

Bug ID: VS-18bd628e
Pattern ID: VS-e9fe47ac
Combined ID: VS-18bd628e (pattern VS-e9fe47ac) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: axe-core — Links must have discernible text [link-name]
Example URL: http://cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
XPath / selector: .field--name-field-description.field--type-text-long.cms-text--prominent > a[href="/media/665791"][data-once="linkMatch"]
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

<a href="/media/665791" data-once="linkMatch"></a>

Description

Links must have discernible text. Detected by axe-core rule link-name on 3 of 1609 scanned pages (6 instances).

Steps to reproduce

Open http://cms.gov/medicare/quality/clinical-laboratory-improvement-amendments.
Locate the element: .field--name-field-description.field--type-text-long.cms-text--prominent > a[href="/media/665791"][data-once="linkMatch"]
Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Serious axe valid-lang WCAG 2.0 AA lang attribute must have a valid value (WCAG 3.1.2) 1/1609 pages · 1 instances Likely content

Bug ID: VS-8f470a84
Pattern ID: VS-dd1c019f
Combined ID: VS-8f470a84 (pattern VS-dd1c019f) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 3.1.2 Language of Parts (Level AA, WCAG 2.0)
Rule: axe-core — lang attribute must have a valid value [valid-lang]
Example URL: https://www.cms.gov/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"]
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

<span lang="X-NONE">[1]</span>

Description

lang attribute must have a valid value. Detected by axe-core rule valid-lang on 1 of 1609 scanned pages (1 instances).

Steps to reproduce

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

Impact

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

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

Affected pages

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

Testing environment

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

Suggested fix

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

Triage status Notes

Serious axe accesskeys Best Practice accesskey attribute value should be unique (WCAG criterion undetermined) 31/1609 pages · 91 instances Likely template

Bug ID: VS-7cf0fd15
Pattern ID: VS-bd13f00a
Combined ID: VS-7cf0fd15 (pattern VS-bd13f00a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — accesskey attribute value should be unique [accesskeys]
Example URL: https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html
XPath / selector: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0216.html"]
History: first seen 2026-W25, last seen 2026-W40 (14 wk)

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

<a accesskey="p" id="prev_page" href="P0216.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 31 of 1609 scanned pages (91 instances).

Steps to reproduce

Open https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html.
Locate the element: td[width="31"]:nth-child(3) > a[accesskey="p"][href$="P0216.html"]
Confirm the axe-core finding for rule accesskeys.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 31 pages (CSV).

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 106/1609 pages · 1507 instances Likely template

Bug ID: VS-2fef1a2b
Pattern ID: VS-f18df681
Combined ID: VS-2fef1a2b (pattern VS-f18df681) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — All page content should be contained by landmarks [region]
Example URL: https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html
XPath / selector: .arrows > tbody > tr:nth-child(1)
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

<tr>
		<td><img src="cms-site-logo.png"></td>
		<td style="text-align:center;"><h1>ICD-10-CM/PCS MS-DRG v39.0 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 106 of 1609 scanned pages (1507 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html.
Locate the element: .arrows > tbody > tr:nth-child(1)
Confirm the axe-core finding for rule region.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 106 pages (CSV).

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Moderate axe landmark-one-main Best Practice Document should have one main landmark (WCAG criterion undetermined) 106/1609 pages · 106 instances Likely template

Bug ID: VS-8dde0e06
Pattern ID: VS-d5d82446
Combined ID: VS-8dde0e06 (pattern VS-d5d82446) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should have one main landmark [landmark-one-main]
Example URL: https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

<html>

Description

Document should have one main landmark. Detected by axe-core rule landmark-one-main on 106 of 1609 scanned pages (106 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html.
Locate the element: html
Confirm the axe-core finding for rule landmark-one-main.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 106 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Minor axe empty-heading Best Practice Headings should not be empty (WCAG criterion undetermined) 104/1609 pages · 104 instances Likely template

Bug ID: VS-3323625b
Pattern ID: VS-0066c67d
Combined ID: VS-3323625b (pattern VS-0066c67d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Headings should not be empty [empty-heading]
Example URL: https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html
XPath / selector: h1:nth-child(2)
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

<h1></h1>

Description

Headings should not be empty. Detected by axe-core rule empty-heading on 104 of 1609 scanned pages (104 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html.
Locate the element: h1:nth-child(2)
Confirm the axe-core finding for rule empty-heading.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 104 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 60/1609 pages · 60 instances Likely template

Bug ID: VS-92a192fd
Pattern ID: VS-c18be945
Combined ID: VS-92a192fd (pattern VS-c18be945) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Scrolling content can be accessed by keyboard [sia-r57]
Example URL: https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
XPath / selector: text: "Feedback"
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 60 of 1609 scanned pages (60 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc.
Locate the element: text: "Feedback"
Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 60 pages (CSV).

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 16/1609 pages · 3262 instances Likely template

Bug ID: VS-a901c4cf
Pattern ID: VS-cb53cc4d
Combined ID: VS-a901c4cf (pattern VS-cb53cc4d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 2.5.5 Target Size (Enhanced) (Level AAA, WCAG 2.1)
Rule: Siteimprove Alfa — Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]
Example URL: https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
XPath / selector: <a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 155 of 1609 scanned pages (5097 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc.
Locate the element: <a href="/about-cms" class="menu-item-link" data-drupal-link-system-path="node/132926" data-once="navigationLinkMatch">
Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 16/1609 pages · 1248 instances Likely template

Bug ID: VS-913ac830
Pattern ID: VS-2208081b
Combined ID: VS-913ac830 (pattern VS-2208081b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has minimum contrast ratio of 4.5:1 [sia-r73]
Example URL: https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
XPath / selector: <p class="ds-c-usa-banner__header-text">
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 153 of 1609 scanned pages (1950 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc.
Locate the element: <p class="ds-c-usa-banner__header-text">
Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 16/1609 pages · 93 instances Likely template

Bug ID: VS-beaaa8b1
Pattern ID: VS-7118fead
Combined ID: VS-beaaa8b1 (pattern VS-7118fead) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field label is visible [sia-r61]
Example URL: https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 146 of 1609 scanned pages (146 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r61.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 14/1609 pages · 151 instances Likely template

Bug ID: VS-ceea4b4b
Pattern ID: VS-04a9d28c
Combined ID: VS-ceea4b4b (pattern VS-04a9d28c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: deprecated-html — Presentational attribute (use CSS) [presentational-attr]
Example URL: https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html
XPath / selector: img
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

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

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 19 of 1609 scanned pages (205 instances).

Steps to reproduce

Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html.
Locate the element: img
Confirm the deprecated-html finding for rule presentational-attr.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

Not captured by automated scan — requires manual testing.

Triage status Notes

Moderate axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 12/1609 pages · 12 instances Likely template

Bug ID: VS-ddafd7b0
Pattern ID: VS-fa44f293
Combined ID: VS-ddafd7b0 (pattern VS-fa44f293) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Page should contain a level-one heading [page-has-heading-one]
Example URL: http://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

<html lang="en" dir="ltr" prefix="og: https://ogp.me/ns#" class=" js" style="--vw: 12.8px; --vh: 8px;">

Description

Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 12 of 1609 scanned pages (12 instances).

Steps to reproduce

Open http://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program.
Locate the element: html
Confirm the axe-core finding for rule page-has-heading-one.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 10/1609 pages · 46 instances Likely template

Bug ID: VS-0b82f0ff
Pattern ID: VS-d25f622d
Combined ID: VS-0b82f0ff (pattern VS-d25f622d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Heading levels should only increase by one [heading-order]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37313&lcdStatus=all&sortBy=title
XPath / selector: #navStickyHeader
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

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

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 114 of 1609 scanned pages (116 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37313&lcdStatus=all&sortBy=title.
Locate the element: #navStickyHeader
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

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

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

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 9/1609 pages · 19 instances Likely template

Bug ID: VS-18fe8f1b
Pattern ID: VS-2cd767ca
Combined ID: VS-18fe8f1b (pattern VS-2cd767ca) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Table header has scope [sia-r78]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all
XPath / selector: <h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 35 of 1609 scanned pages (52 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all.
Locate the element: <h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">
Confirm the Siteimprove Alfa finding for rule sia-r78.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r4 WCAG 2.0 A Document has a valid lang attribute (WCAG 3.1.1) 9/1609 pages · 9 instances

Bug ID: VS-6042c338
Pattern ID: VS-7a0e5645
Combined ID: VS-6042c338 (pattern VS-7a0e5645) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 3.1.1 Language of Page (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Document has a valid lang attribute [sia-r4]
Example URL: http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
XPath / selector: <html>
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

Description

Document has a valid lang attribute. Detected by Siteimprove Alfa rule sia-r4 on 9 of 1609 scanned pages (9 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html.
Locate the element: <html>
Confirm the Siteimprove Alfa finding for rule sia-r4 against WCAG 3.1.1 Language of Page.

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r64 WCAG 2.0 A Element has required owned roles (WCAG 1.3.1) 8/1609 pages · 8 instances · possible duplicate

Bug ID: VS-5e0b268b
Pattern ID: VS-3c632d31
Combined ID: VS-5e0b268b (pattern VS-3c632d31) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Element has required owned roles [sia-r64]
Example URL: http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
XPath / selector: <h1>
History: first seen 2026-W24, last seen 2026-W40 (17 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-6c8476fd (pattern VS-6175596b). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Element has required owned roles. Detected by Siteimprove Alfa rule sia-r64 on 8 of 1609 scanned pages (8 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html.
Locate the element: <h1>
Confirm the Siteimprove Alfa finding for rule sia-r64 against WCAG 1.3.1 Info and Relationships.

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 8/1609 pages · 8 instances

Bug ID: VS-836665b9
Pattern ID: VS-a24eaa8c
Combined ID: VS-836665b9 (pattern VS-a24eaa8c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Image has accessible name [sia-r2]
Example URL: http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
XPath / selector: <img src="cms-site-logo.png">
History: first seen 2026-W24, last seen 2026-W40 (16 wk)

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 8 of 1609 scanned pages (8 instances).

Steps to reproduce

Open http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html.
Locate the element: <img src="cms-site-logo.png">
Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 7/1609 pages · 23 instances Likely template

Bug ID: VS-0d6d568e
Pattern ID: VS-179ad9b3
Combined ID: VS-0d6d568e (pattern VS-179ad9b3) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.2 AA
Obligation: required
Handling: review
WCAG SC: 2.5.8 Target Size (Minimum) (Level AA, WCAG 2.2)
Rule: Siteimprove Alfa — Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]
Example URL: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
XPath / selector: <a href="#h3CmsNationalCoveragePolicyHeader" data-href="h3CmsNationalCoveragePolicyHeader" class="nav-link toc-link no-link log-click" title="Jump to CMS National Coverage Policy">
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 29 of 1609 scanned pages (82 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7.
Locate the element: <a href="#h3CmsNationalCoveragePolicyHeader" data-href="h3CmsNationalCoveragePolicyHeader" class="nav-link toc-link no-link log-click" title="Jump to CMS National Coverage Policy">
Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r53 Undetermined Headings are structured hierarchically (WCAG criterion undetermined) 3/1609 pages · 6 instances Likely template

Bug ID: VS-0642f1ce
Pattern ID: VS-f054f4a4
Combined ID: VS-0642f1ce (pattern VS-f054f4a4) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Headings are structured hierarchically [sia-r53]
Example URL: http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
XPath / selector: <h3 id="h3GeneralInformationHeader" class="document-view-section-header">
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 53 of 1609 scanned pages (53 instances).

Steps to reproduce

Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6.
Locate the element: <h3 id="h3GeneralInformationHeader" class="document-view-section-header">
Confirm the Siteimprove Alfa finding for rule sia-r53.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate axe scope-attr-valid Best Practice scope attribute should be used correctly (WCAG criterion undetermined) 2/1609 pages · 40 instances Likely template

Bug ID: VS-50cc258f
Pattern ID: VS-0ba8ce9d
Combined ID: VS-50cc258f (pattern VS-0ba8ce9d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — scope attribute should be used correctly [scope-attr-valid]
Example URL: https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
XPath / selector: .MsoNormalTable[border="1"]:nth-child(42) > tbody > tr:nth-child(2) > td[scope="row"][valign="top"]
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

<td valign="top" scope="row">  <p>November 18, 2013</p></td>

Description

scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 14 of 1609 scanned pages (280 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273.
Locate the element: .MsoNormalTable[border="1"]:nth-child(42) > tbody > tr:nth-child(2) > td[scope="row"][valign="top"]
Confirm the axe-core finding for rule scope-attr-valid.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Minor axe empty-table-header Best Practice Table header text should not be empty (WCAG criterion undetermined) 2/1609 pages · 3 instances

Bug ID: VS-d20c69a7
Pattern ID: VS-d69fc059
Combined ID: VS-d20c69a7 (pattern VS-d69fc059) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Table header text should not be empty [empty-table-header]
Example URL: https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
XPath / selector: .MsoNormalTable[border="1"]:nth-child(90) > tbody > tr:nth-child(1) > th:nth-child(1)
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

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

<th scope="col">&nbsp;</th>

Description

Table header text should not be empty. Detected by axe-core rule empty-table-header on 9 of 1609 scanned pages (15 instances).

Steps to reproduce

Open https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273.
Locate the element: .MsoNormalTable[border="1"]:nth-child(90) > tbody > tr:nth-child(1) > th:nth-child(1)
Confirm the axe-core finding for rule empty-table-header.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r46 WCAG 2.0 A Element has required aria-owns (WCAG 1.3.1) 1/1609 pages · 2 instances · possible duplicate

Bug ID: VS-412f6d8a
Pattern ID: VS-4408605e
Combined ID: VS-412f6d8a (pattern VS-4408605e) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Element has required aria-owns [sia-r46]
Example URL: https://www.cms.gov/medicare-coverage-database/view/article.aspx?areaId=all&articleid=58592&bc=1&contractOption=all&docType=6%2C1&keyword=cataract+extraction&keywordType=all&sortBy=relevance&ver=14
XPath / selector: <th scope="col">
History: first seen 2026-W25, last seen 2026-W40 (16 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-6c8476fd (pattern VS-6175596b). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 9 of 1609 scanned pages (17 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/view/article.aspx?areaId=all&articleid=58592&bc=1&contractOption=all&docType=6%2C1&keyword=cataract+extraction&keywordType=all&sortBy=relevance&ver=14.
Locate the element: <th scope="col">
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

/newsroom/fact-sheets/marketplace-2024-open-enrollment-period-report-national-snapshot-2

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

Triage status Notes

Moderate alfa sia-r75 Undetermined Form field error is identified and described (WCAG criterion undetermined) 1/1609 pages · 2 instances Likely content

Bug ID: VS-f1539438
Pattern ID: VS-e43903a1
Combined ID: VS-f1539438 (pattern VS-e43903a1) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field error is identified and described [sia-r75]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html
XPath / selector: <ul id="globar">
History: first seen 2026-W26, last seen 2026-W40 (14 wk)

Description

Form field error is identified and described. Detected by Siteimprove Alfa rule sia-r75 on 1 of 1609 scanned pages (2 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html.
Locate the element: <ul id="globar">
Confirm the Siteimprove Alfa finding for rule sia-r75.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/icd10m/version33-fullcode-cms/fullcode_cms/P1360.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

Triage status Notes

Moderate alfa sia-r11 WCAG 2.0 A Link has accessible name (WCAG 2.4.4) 1/1609 pages · 2 instances Likely content

Bug ID: VS-b3a1773a
Pattern ID: VS-28ebd979
Combined ID: VS-b3a1773a (pattern VS-28ebd979) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Link has accessible name [sia-r11]
Example URL: https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
XPath / selector: <a href="/media/665791" data-once="linkMatch">
History: first seen 2026-W24, last seen 2026-W40 (14 wk)

Description

Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 1609 scanned pages (2 instances).

Steps to reproduce

Open https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments.
Locate the element: <a href="/media/665791" data-once="linkMatch">
Confirm the Siteimprove Alfa finding for rule sia-r11 against WCAG 2.4.4 Link Purpose (In Context).

Impact

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

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

Affected pages

/medicare/quality/clinical-laboratory-improvement-amendments

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r68 WCAG 2.0 A Presentational children of an element are not focusable (WCAG 1.3.1) 1/1609 pages · 2 instances Likely template

Bug ID: VS-62564f9c
Pattern ID: VS-d6097011
Combined ID: VS-62564f9c (pattern VS-d6097011) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Presentational children of an element are not focusable [sia-r68]
Example URL: https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all
XPath / selector: <tfoot>
History: first seen 2026-W24, last seen 2026-W40 (17 wk)

Description

Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 19 of 1609 scanned pages (36 instances).

Steps to reproduce

Open https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all.
Locate the element: <tfoot>
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

/icd10m/version37-fullcode-cms/fullcode_cms/P0014.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-r68

Triage status Notes

Moderate alfa sia-r59 Undetermined Element with orientation is not locked (WCAG criterion undetermined) 1/1609 pages · 1 instances Likely content

Bug ID: VS-d6bcda0c
Pattern ID: VS-7fbb8b20
Combined ID: VS-d6bcda0c (pattern VS-7fbb8b20) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Element with orientation is not locked [sia-r59]
Example URL: https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html
XPath / selector: {"type":"document","children":[{"type":"element","children":[{"type":"element","
History: first seen 2026-W26, last seen 2026-W40 (14 wk)

Description

Element with orientation is not locked. Detected by Siteimprove Alfa rule sia-r59 on 1 of 1609 scanned pages (1 instances).

Steps to reproduce

Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html.
Locate the element: {"type":"document","children":[{"type":"element","children":[{"type":"element","
Confirm the Siteimprove Alfa finding for rule sia-r59.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/icd10m/version33-fullcode-cms/fullcode_cms/P1360.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

Triage status Notes

Moderate axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 1/1609 pages · 1 instances Likely content

Bug ID: VS-bbb55d53
Pattern ID: VS-8806389c
Combined ID: VS-bbb55d53 (pattern VS-8806389c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Landmarks should have a unique role or role/label/title (i.e. accessible name) c [landmark-unique]
Example URL: http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4474&page=1
XPath / selector: .views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)
History: first seen 2026-W25, last seen 2026-W40 (16 wk)

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

<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 1 of 1609 scanned pages (1 instances).

Steps to reproduce

Open http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4474&page=1.
Locate the element: .views-field-field-topic[aria-label="Related search topics"][role="region"]:nth-child(1)
Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/apps/media/press/factsheet.asp

Testing environment

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

Suggested fix

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

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

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (19 rule type(s))

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

axe-core rules failing in 2026-W40, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Links must be distinguishable without relying on color [link-in-text-block]	serious	141	324	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 141 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	114	116	/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx	all 114 pages (CSV)
All page content should be contained by landmarks [region]	moderate	106	1507	/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html /icd10m/version38-fullcode-cms/fullcode_cms/P0974.html	all 106 pages (CSV)
<html> element must have a lang attribute [html-has-lang]	serious	106	106	/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html /icd10m/version38-fullcode-cms/fullcode_cms/P0974.html	all 106 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	106	106	/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html /icd10m/version38-fullcode-cms/fullcode_cms/P0974.html	all 106 pages (CSV)
Headings should not be empty [empty-heading]	minor	104	104	/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html /icd10m/version38-fullcode-cms/fullcode_cms/P0974.html	all 104 pages (CSV)
Images must have alternative text [image-alt]	critical	100	100	/icd10m/version39-fullcode-cms/fullcode_cms/P0178.html /icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html /icd10m/version38-fullcode-cms/fullcode_cms/P0974.html	all 100 pages (CSV)
<ul> and <ol> must only directly contain <li>, <script> or <template> elements [list]	serious	90	645	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx	all 90 pages (CSV)
accesskey attribute value should be unique [accesskeys]	serious	31	91	/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html /icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0482.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html	all 31 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	14	280	/medicare-coverage-database/details/nca-decision-memo.aspx /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html	all 14 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	12	12	/medicare/medicaid-coordination/states/medicaid-integrity-program /medicaid-chip/community-engagement-support/eligibility-made-easy /icd10m/version33-fullcode-cms/fullcode_cms/P1323.html	all 12 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	10	186	/medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx /icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html	all 10 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	9	15	/medicare-coverage-database/details/nca-decision-memo.aspx /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html	all 9 pages (CSV)
<li> elements must be contained in a <ul> or <ol> [listitem]	serious	7	115	/medicare-coverage-database/details/nca-decision-memo.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 7 pages (CSV)
Form elements must have labels [label]	critical	6	6	/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html /icd10m/version33-fullcode-cms/fullcode_cms/P0448.html /icd10m/version33-fullcode-cms/fullcode_cms/P1518.html	all 6 pages (CSV)
Links must have discernible text [link-name]	serious	3	6	/medicare/quality/clinical-laboratory-improvement-amendments /medicare/quality/clinical-laboratory-improvement-amendments /medicare-coverage-database/view/ncacal-decision-memo.aspx	all 3 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	1	1	/apps/media/press/factsheet.asp	all 1 pages (CSV)
lang attribute must have a valid value [valid-lang]	serious	1	1	/data-research/monitoring-programs/improper-payment-measurement-programs/exchange-improper-payment-measurement-eipm/improper-payment-findings	all 1 pages (CSV)
Scrollable region must have keyboard access [scrollable-region-focusable]	serious	1	1	/medicare-coverage-database/view/ncacal-decision-memo.aspx	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (22 rule type(s))

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

Alfa rules failing in 2026-W40, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	155	5097	/medicare/regulations-guidance/transmittals/2025-transmittals /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncd.aspx	all 155 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	153	1950	/medicare/regulations-guidance/transmittals/2025-transmittals /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncd.aspx	all 153 pages (CSV)
Form field label is visible [sia-r61]	n/a	146	146	/medicare/regulations-guidance/transmittals/2025-transmittals /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncd.aspx	all 146 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	60	60	/medicare/regulations-guidance/transmittals/2025-transmittals /about-cms/what-we-do/emergency-response/how-can-we-help /medicare/regulations-guidance/transmittals/2015-transmittals	all 60 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	54	3124	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/lcd.aspx	all 54 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	54	643	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/lcd.aspx	all 54 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	54	153	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/ncd.aspx /medicare-coverage-database/view/lcd.aspx	all 54 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	53	53	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx	all 53 pages (CSV)
Table header has scope [sia-r78]	n/a	35	52	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/article.aspx /cms-l564-request-employment-information	all 35 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	29	82	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 29 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	19	36	/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx	all 19 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	9	17	/medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx /medicare-coverage-database/view/article.aspx	all 9 pages (CSV)
Document has a valid lang attribute [sia-r4]	n/a	9	9	/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html	all 9 pages (CSV)
Image has accessible name [sia-r2]	n/a	8	8	/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html	all 8 pages (CSV)
Element has required owned roles [sia-r64]	n/a	8	8	/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html /icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html /icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html	all 8 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	6	62	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 6 pages (CSV)
iframe element is not empty [sia-r71]	n/a	3	21	/medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/lcd.aspx /medicare-coverage-database/view/article.aspx	all 3 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	1	2	/medicare-coverage-database/view/lcd.aspx	all 1 pages (CSV)
Link has accessible name [sia-r11]	n/a	1	2	/medicare/quality/clinical-laboratory-improvement-amendments	all 1 pages (CSV)
Form field error is identified and described [sia-r75]	n/a	1	2	/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html	all 1 pages (CSV)
Duplicate role landmark is labeled [sia-r79]	n/a	1	1	/medicare-coverage-database/view/ncacal-decision-memo.aspx	all 1 pages (CSV)
Element with orientation is not locked [sia-r59]	n/a	1	1	/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html	all 1 pages (CSV)

Unique accessibility issues (axe + Alfa consolidated)

axe and Alfa both implement W3C ACT rules, so the same issue is often caught by both. These are deduplicated by ACT rule and page, so a shared finding counts once (1822 raw engine findings → 1796 unique).

Unique issues (rule × page): 1796
Caught by both engines: 26 highest confidence
axe only: 936
Alfa only: 834

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

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

Rules flagged by both axe-core and Alfa in 2026-W40, by pages affected.
Issue	Pages	Rule references
<html> element must have a lang attribute	106	axe html-has-lang · Alfa sia-r4 · ACT b5c3f8
Headings should not be empty	104	axe empty-heading · Alfa sia-r64 · ACT ffd0e9
Images must have alternative text	100	axe image-alt · Alfa sia-r2 · ACT 23a2a8
Links must have discernible text	3	axe link-name · Alfa sia-r11 · ACT c487ae