# Accessibility bug reports — www.cms.gov, week 2026-W40

42 issue type(s) from 1609 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-0d6d568e`  
**Pattern ID:** `VS-179ad9b3`  
**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">`  
**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:** 82 instances; 29 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### 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
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7.
2. 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">
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/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55451&ver=2
- 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
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56471&articleStatus=all&bc=3&sortBy=title&ver=18
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59434&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35073&ver=51
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=26
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56614&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=20
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0052.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0014.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=53079&articleStatus=all&bc=3&sortBy=title&ver=25
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56425&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=15
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0117.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57863&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=41
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33824
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58747&articleStatus=all&bc=3&sortBy=title&ver=63
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59055&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- 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=9
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57130&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=51
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55229&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=40

…and more — 29 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/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55451&ver=2
- 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

---

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

**Bug ID:** `VS-2dbf060d`  
**Pattern ID:** `VS-f7dba940`  
**URL:** http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6  
**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:** 153 instances; 54 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 54 of 1609 scanned pages (153 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6.
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
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- 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
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55451&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60176&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34833&lcdStatus=all&sortBy=title&stateRegion=all&ver=94
- 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
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=22
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52505&ver=77
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33736&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56471&articleStatus=all&bc=3&sortBy=title&ver=18
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59434&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38371&lcdStatus=all&sortBy=title&ver=10
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=32
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33830&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/nca.aspx?bc=14&doctype=all&ncaid=277&sortBy=title&year=2026
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35073&ver=51
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=26
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56614&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35080&lcdStatus=all&sortBy=title&ver=53
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=20

…and more — 54 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
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7

---

## Images must have alternative text (WCAG 1.1.1)

**Bug ID:** `VS-80f5a637`  
**Pattern ID:** `VS-9074b4dd`  
**URL:** https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.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:** 100 instances; 100 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (16 weeks)

### HTML snippet
```html
<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
1. Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.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/version39-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0120.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0482.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html
- http://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0018.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0057.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0286.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0157.html
- https://cms.gov/icd10m/version40-fullcode-cms/fullcode_cms/P0005.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0219.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0488.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0672.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0289.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0013.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P1741.html

…and more — 100 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/version39-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html

---

## Image has accessible name (WCAG 1.1.1)

**Bug ID:** `VS-836665b9`  
**Pattern ID:** `VS-a24eaa8c`  
**URL:** http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.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:** 8 instances; 8 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (16 weeks)

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

### Steps to reproduce
1. Open http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.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-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0052.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0014.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0117.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0158.html

### 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-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html

---

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

**Bug ID:** `VS-e215c0cb`  
**Pattern ID:** `VS-a0bdbdf6`  
**URL:** http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56472&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22  
**XPath / selector:** `#lblCmsNationalCoveragePolicy > ul:nth-child(3)`  
**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:** 645 instances; 90 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<ul style="box-sizing: border-b...">
```

### Description
<ul> and <ol> must only directly contain <li>, <script> or <template> elements. Detected by axe-core rule list on 90 of 1609 scanned pages (645 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56472&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22.
2. Locate the element: #lblCmsNationalCoveragePolicy > ul:nth-child(3)
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
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56472&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33785&lcdStatus=all&sortBy=title&ver=40
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37281&lcdStatus=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56696&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=44
- https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33579&lcdStatus=all&sortBy=title&stateRegion=all&ver=39
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36920&lcdStatus=all&sortBy=title&ver=90
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=27
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33446&lcdStatus=all&sortBy=title&ver=47
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56230&articleStatus=all&bc=3&sortBy=title&ver=3
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35001&lcdStatus=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=39036&lcdStatus=all&sortBy=title&stateRegion=all&ver=20
- 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
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33626&ver=45
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40226&proposedStatus=all&sortBy=title&stateRegion=all&ver=4
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34228&lcdStatus=all&sortBy=title&stateRegion=all&ver=54
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37535&lcdStatus=all&sortBy=title&stateRegion=all&ver=18
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=40352&ver=6
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35702&lcdStatus=all&sortBy=title&ver=25
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39314&ver=12
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33686&lcdStatus=all&sortBy=title&ver=43
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33756&lcdStatus=all&sortBy=title&stateRegion=all&ver=23
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56538&ver=24
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?areaId=all&bc=1&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=38310&sortBy=relevance&ver=11
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36920&lcdStatus=all&sortBy=title&ver=92

…and more — 90 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
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56472&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33785&lcdStatus=all&sortBy=title&ver=40
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37281&lcdStatus=all&sortBy=title&ver=23

---

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

**Bug ID:** `VS-6c8476fd`  
**Pattern ID:** `VS-6175596b`  
**URL:** https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273  
**XPath / selector:** `li:nth-child(40)`  
**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:** 115 instances; 7 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<li> When performed outside a controlled clinical study, how do outcomes and adverse events compare to the pivotal clinical studies?<p></p>  
  
</li>
```

### Description
<li> elements must be contained in a <ul> or <ol>. Detected by axe-core rule listitem on 7 of 1609 scanned pages (115 instances).

### Steps to reproduce
1. Open https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273.
2. Locate the element: li:nth-child(40)
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://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&ver=19
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=264&proposed=N
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34183&lcdStatus=all&sortBy=title&ver=20
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&ver=20
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=Y
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N

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

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34183&lcdStatus=all&sortBy=title&ver=19
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=264&proposed=N

---

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

**Bug ID:** `VS-62564f9c`  
**Pattern ID:** `VS-d6097011`  
**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>`  
**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:** 36 instances; 19 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### 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
1. 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.
2. Locate the element: <tfoot>
3. Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all
- 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
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33736&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=32
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33830&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/nca.aspx?bc=14&doctype=all&ncaid=277&sortBy=title&year=2026
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35080&lcdStatus=all&sortBy=title&ver=53
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38773&lcdStatus=all&sortBy=title
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0014.html
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=34149&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=name&contractorName=5&docType=NCA%2CCAL%2CNCD%2CMEDCAC%2CTA%2CMCD%2C6%2C3%2C5%2C1%2CF%2CP&keyword=defining&keywordType=starts&lcdid=40410&sortBy=relevance
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39240&lcdStatus=all&sortBy=title&ver=8
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34074&lcdStatus=all&sortBy=title&ver=39
- 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=9
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33633&lcdStatus=all&sortBy=title&ver=50
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55229&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=40
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56786&ver=73
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38680&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39242&sortBy=relevance

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all
- 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
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33736&lcdStatus=all&sortBy=title

---

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

**Bug ID:** `VS-412f6d8a`  
**Pattern ID:** `VS-4408605e`  
**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">`  
**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:** 17 instances; 9 of 1609 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W40 (16 weeks)

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

### Steps to reproduce
1. 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.
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?areaId=all&articleid=58592&bc=1&contractOption=all&docType=6%2C1&keyword=cataract+extraction&keywordType=all&sortBy=relevance&ver=14
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56425&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=15
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57863&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=41
- https://www.cms.gov/newsroom/fact-sheets/marketplace-2024-open-enrollment-period-report-national-snapshot-2
- 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=9
- https://cms.gov/medicare-coverage-database/view/article.aspx?articleid=57130&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=51
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55229&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=40
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=56786&ver=73
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54969&articleStatus=all&bc=3&sortBy=title&ver=52

### 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?areaId=all&articleid=58592&bc=1&contractOption=all&docType=6%2C1&keyword=cataract+extraction&keywordType=all&sortBy=relevance&ver=14
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56425&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=15
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57863&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=41

---

## Element has required owned roles (WCAG 1.3.1)

**Bug ID:** `VS-5e0b268b`  
**Pattern ID:** `VS-3c632d31`  
**URL:** http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.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:** 8 instances; 8 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

### Steps to reproduce
1. Open http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.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-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0052.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0014.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0117.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0158.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-r64

### Example pages
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html

---

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

**Bug ID:** `VS-36071e7c`  
**Pattern ID:** `VS-8ade3360`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36406&lcdStatus=all&sortBy=title&ver=10  
**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:** 324 instances; 141 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<a href="https://localcoverage.cms.gov/mcd_archive/view/lcd.aspx?lcdInfo=36405:9" target="_blank" class="log-click system-link" data-page-action="Clicked the Source Proposed LCD link">DL36406</a>
```

### Description
Links must be distinguishable without relying on color. Detected by axe-core rule link-in-text-block on 141 of 1609 scanned pages (324 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36406&lcdStatus=all&sortBy=title&ver=10.
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=36406&lcdStatus=all&sortBy=title&ver=10
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34051&lcdStatus=all&sortBy=title&ver=43
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37015&lcdStatus=all&sortBy=title&ver=27
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=11&contractorNumber=all&lcdid=40238&proposedStatus=all&sortBy=title&stateRegion=all&ver=3
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34417&lcdStatus=all&sortBy=title&ver=57
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=40168&lcdStatus=all&sortBy=title&ver=8
- https://www.cms.gov/medicare-coverage-database/view/nca.aspx?bc=17&ncacaldoctype=all&ncaid=65&sortBy=status&status=all
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37281&lcdStatus=all&sortBy=title&ver=23
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37373&lcdStatus=all&sortBy=title&stateRegion=all&ver=31
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38664&lcdStatus=all&sortBy=title&ver=26
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=36139&lcdStatus=all&sortBy=title&stateRegion=all&ver=30
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35016&lcdStatus=all&sortBy=title&ver=36
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=40329&ver=5
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=33579&lcdStatus=all&sortBy=title&stateRegion=all&ver=39
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38178&lcdStatus=all&sortBy=title&ver=11
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37022&lcdStatus=all&sortBy=title&ver=30
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36675&lcdStatus=all&sortBy=title&ver=19
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=36920&lcdStatus=all&sortBy=title&ver=90
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=37360&lcdStatus=all&sortBy=title&ver=21
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=33787&lcdStatus=all&sortBy=title&ver=38
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=38773&lcdStatus=all&sortBy=title&ver=27
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36704&lcdStatus=all&sortBy=title&ver=20

…and more — 141 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=36406&lcdStatus=all&sortBy=title&ver=10
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=34051&lcdStatus=all&sortBy=title&ver=43
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=37015&lcdStatus=all&sortBy=title&ver=27

---

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

**Bug ID:** `VS-3b4f636d`  
**Pattern ID:** `VS-efd91fdd`  
**URL:** http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43  
**XPath / selector:** `<a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_23">`  
**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:** 2 instances; 1 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (16 weeks)

### Description
Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 1 of 1609 scanned pages (2 instances).

### Steps to reproduce
1. Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43.
2. Locate the element: <a href="#" data-bs-toggle="modal" data-bs-target="#MCDNoticeBoadModal" id="aBoardItemLink_23">
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
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43

### 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

---

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

**Bug ID:** `VS-7b279600`  
**Pattern ID:** `VS-c613c153`  
**URL:** https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=183&proposed=N  
**XPath / selector:** `pre`  
**WCAG SC:** 2.1.1 — Keyboard (Level A)  
**Rule:** axe-core — `scrollable-region-focusable` ([reference](https://dequeuniversity.com/rules/axe/4.12/scrollable-region-focusable?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 1 instances; 1 of 1609 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W40 (12 weeks)

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

### Description
Scrollable region must have keyboard access. Detected by axe-core rule scrollable-region-focusable on 1 of 1609 scanned pages (1 instances).

### Steps to reproduce
1. Open https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=183&proposed=N.
2. Locate the element: pre
3. Confirm the axe-core finding for rule scrollable-region-focusable against WCAG 2.1.1 Keyboard.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?calid=183&proposed=N

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

### Suggested fix
**How to fix:** Make scrollable regions keyboard-focusable (tabindex="0") so keyboard users can scroll them.

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

---

## Links must have discernible text (WCAG 2.4.4)

**Bug ID:** `VS-18bd628e`  
**Pattern ID:** `VS-e9fe47ac`  
**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"]`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** axe-core — `link-name` ([reference](https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 6 instances; 3 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

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

### Affected pages
- http://cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=Y

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

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

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

### Example pages
- http://cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=Y

---

## Link has accessible name (WCAG 2.4.4)

**Bug ID:** `VS-b3a1773a`  
**Pattern ID:** `VS-28ebd979`  
**URL:** https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments  
**XPath / selector:** `<a href="/media/665791" data-once="linkMatch">`  
**WCAG SC:** 2.4.4 — Link Purpose (In Context) (Level A)  
**Rule:** Siteimprove Alfa — `sia-r11` ([reference](https://alfa.siteimprove.com/rules/sia-r11))  
**Severity:** Moderate  
**Frequency:** 2 instances; 1 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (14 weeks)

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

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

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

### Affected pages
- https://www.cms.gov/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

---

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

**Bug ID:** `VS-ad03df9f`  
**Pattern ID:** `VS-c126b6a6`  
**URL:** https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.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:** 106 instances; 106 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<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
1. Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.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/version39-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0120.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0482.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html
- http://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0018.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0057.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0286.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0157.html
- https://cms.gov/icd10m/version40-fullcode-cms/fullcode_cms/P0005.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0219.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0488.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0672.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0289.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0013.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html

…and more — 106 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/version39-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html

---

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

**Bug ID:** `VS-6042c338`  
**Pattern ID:** `VS-7a0e5645`  
**URL:** http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.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:** 9 instances; 9 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

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

### Affected pages
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0052.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0014.html
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0117.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0158.html
- https://www.cms.gov/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
**How to fix:** Add a valid lang attribute to <html>.

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

### Example pages
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html

---

## Form elements must have labels (WCAG 4.1.2)

**Bug ID:** `VS-dc3e2cbb`  
**Pattern ID:** `VS-fafffee0`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.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:** 6 instances; 6 of 1609 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W40 (15 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 6 of 1609 scanned pages (6 instances).

### Steps to reproduce
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.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/P1323.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0448.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1518.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1352.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0139.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.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/P1323.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0448.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1518.html

---

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

**Bug ID:** `VS-82d289f1`  
**Pattern ID:** `VS-be8d563e`  
**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)`  
**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:** 186 instances; 10 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<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
1. Open https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273.
2. Locate the element: em:nth-child(326) > font > p:nth-child(1)
3. Confirm the axe-core finding for rule color-contrast against WCAG 1.4.3 Contrast (Minimum).

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

### Affected pages
- https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36704&lcdStatus=all&sortBy=title&ver=20
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0220.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0268.html
- https://www.cms.gov/medicare-coverage-database/details/nca-proposed-decision-memo.aspx?NCAId=301
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0142.html
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=ABAAAAAAIAAA&NCAId=299&ncdid=281&ncdver=8&type=Open
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=33803&lcdStatus=all&sortBy=title&ver=53
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=187&proposed=N

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

### Suggested fix
**How to fix:** Increase the contrast between text and its background to at least 4.5:1 (3:1 for large text). Check both light and dark modes.

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

### Example pages
- https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36704&lcdStatus=all&sortBy=title&ver=20
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html

---

## 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 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 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 1609 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-ed5d8d1e`  
**Pattern ID:** `VS-646b1e0b`  
**URL:** http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6  
**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:** 643 instances; 54 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 54 of 1609 scanned pages (643 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6.
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
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- 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
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55451&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60176&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34833&lcdStatus=all&sortBy=title&stateRegion=all&ver=94
- 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
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=22
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52505&ver=77
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33736&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56471&articleStatus=all&bc=3&sortBy=title&ver=18
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59434&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38371&lcdStatus=all&sortBy=title&ver=10
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=32
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33830&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/nca.aspx?bc=14&doctype=all&ncaid=277&sortBy=title&year=2026
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35073&ver=51
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=26
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56614&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35080&lcdStatus=all&sortBy=title&ver=53
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=20

…and more — 54 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
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7

---

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

**Bug ID:** `VS-913ac830`  
**Pattern ID:** `VS-2208081b`  
**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">`  
**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:** 1950 instances; 153 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

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

### Affected pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3
- https://www.cms.gov/about-cms/what-we-do/emergency-response/how-can-we-help
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- https://cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_cr_number&page=12&sort=asc
- 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
- https://www.cms.gov/about-cms/information-systems/privacy/privacy-act-1974-and-privacy-act-requests
- https://www.cms.gov/about-cms/contact/database?page=206
- https://www.cms.gov/priorities/innovation/cgt-access-model-frequently-asked-questions
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55451&ver=2
- https://www.cms.gov/marketplace/about/exchange-coverage-maps
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60176&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43
- http://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/cms-l564-request-employment-information
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34833&lcdStatus=all&sortBy=title&stateRegion=all&ver=94
- https://cms.gov/medicare/cms-forms/cms-forms/cms-forms-items/cms056691
- https://www.cms.gov/
- https://cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals/r13280cp
- https://www.cms.gov/data-research/cms-information-technology/sparc/how-to-use-sparc/step-1-sparc-scope
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10720otn
- https://www.cms.gov/training-education/medicare-learning-networkr-mln/resources-training/mln-publications-multimedia
- https://www.cms.gov/medicare/advantage-quality-improvement-program/objectives

…and more — 153 pages total ([download CSV](csv/alfa__sia-r73.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3

---

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

**Bug ID:** `VS-bf3da8e4`  
**Pattern ID:** `VS-fbf54eba`  
**URL:** http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6  
**XPath / selector:** `<p class="mb-2">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r74` ([reference](https://alfa.siteimprove.com/rules/sia-r74))  
**Severity:** Moderate  
**Frequency:** 3124 instances; 54 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 54 of 1609 scanned pages (3124 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6.
2. Locate the element: <p class="mb-2">
3. Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- 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
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55451&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60176&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34833&lcdStatus=all&sortBy=title&stateRegion=all&ver=94
- 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
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?medcacid=22
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52505&ver=77
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33736&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56471&articleStatus=all&bc=3&sortBy=title&ver=18
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59434&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38371&lcdStatus=all&sortBy=title&ver=10
- https://cms.gov/medicare-coverage-database/view/nca.aspx?ncaid=32
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33830&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/view/nca.aspx?bc=14&doctype=all&ncaid=277&sortBy=title&year=2026
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35073&ver=51
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=26
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56614&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35080&lcdStatus=all&sortBy=title&ver=53
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=20

…and more — 54 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
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7

---

## Scrollable element is keyboard accessible (WCAG 1.4.8)

**Bug ID:** `VS-b1c4a416`  
**Pattern ID:** `VS-388b5438`  
**URL:** http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&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:** 62 instances; 6 of 1609 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W40 (16 weeks)

### Description
Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 6 of 1609 scanned pages (62 instances).

### Steps to reproduce
1. Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&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
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39240&lcdStatus=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58747&articleStatus=all&bc=3&sortBy=title&ver=63
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59055&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=11
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54969&articleStatus=all&bc=3&sortBy=title&ver=52
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59056&articleStatus=all&bc=3&sortBy=title&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-r80

### Example pages
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39240&lcdStatus=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58747&articleStatus=all&bc=3&sortBy=title&ver=63

---

## iframe element is not empty (WCAG 1.4.8)

**Bug ID:** `VS-37f6e070`  
**Pattern ID:** `VS-48291402`  
**URL:** http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&ver=8  
**XPath / selector:** `<p style="background: white; text-align: justify;">`  
**WCAG SC:** 1.4.8 — Visual Presentation (Level AAA)  
**Rule:** Siteimprove Alfa — `sia-r71` ([reference](https://alfa.siteimprove.com/rules/sia-r71))  
**Severity:** Moderate  
**Frequency:** 21 instances; 3 of 1609 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W40 (16 weeks)

### Description
iframe element is not empty. Detected by Siteimprove Alfa rule sia-r71 on 3 of 1609 scanned pages (21 instances).

### Steps to reproduce
1. Open http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&ver=8.
2. Locate the element: <p style="background: white; text-align: justify;">
3. Confirm the Siteimprove Alfa finding for rule sia-r71 against WCAG 1.4.8 Visual Presentation.

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

### Affected pages
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&ver=8
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39240&lcdStatus=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54969&articleStatus=all&bc=3&sortBy=title&ver=52

### 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://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&ver=8
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39240&lcdStatus=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=54969&articleStatus=all&bc=3&sortBy=title&ver=52

---

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

**Bug ID:** `VS-a901c4cf`  
**Pattern ID:** `VS-cb53cc4d`  
**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">`  
**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:** 5097 instances; 155 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

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

### Affected pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3
- https://www.cms.gov/about-cms/what-we-do/emergency-response/how-can-we-help
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- https://cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_cr_number&page=12&sort=asc
- 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
- https://www.cms.gov/about-cms/information-systems/privacy/privacy-act-1974-and-privacy-act-requests
- https://www.cms.gov/about-cms/contact/database?page=206
- https://www.cms.gov/priorities/innovation/cgt-access-model-frequently-asked-questions
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55451&ver=2
- https://www.cms.gov/marketplace/about/exchange-coverage-maps
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60176&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43
- http://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/cms-l564-request-employment-information
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34833&lcdStatus=all&sortBy=title&stateRegion=all&ver=94
- https://cms.gov/medicare/cms-forms/cms-forms/cms-forms-items/cms056691
- https://www.cms.gov/
- https://cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals/r13280cp
- https://www.cms.gov/data-research/cms-information-technology/sparc/how-to-use-sparc/step-1-sparc-scope
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10720otn
- https://www.cms.gov/training-education/medicare-learning-networkr-mln/resources-training/mln-publications-multimedia
- https://www.cms.gov/medicare/advantage-quality-improvement-program/objectives

…and more — 155 pages total ([download CSV](csv/alfa__sia-r111.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3

---

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

**Bug ID:** `VS-7cf0fd15`  
**Pattern ID:** `VS-bd13f00a`  
**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"]`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `accesskeys` ([reference](https://dequeuniversity.com/rules/axe/4.12/accesskeys?application=axeAPI))  
**Severity:** Serious  
**Frequency:** 91 instances; 31 of 1609 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W40 (14 weeks)

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

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

### Affected pages
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0482.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0157.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0488.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P1741.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1722.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P2001.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0220.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0189.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0268.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0325.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0130.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0113.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0142.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0971.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0392.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0759.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0304.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0358.html

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

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

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

### Example pages
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0482.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html

---

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

**Bug ID:** `VS-0b82f0ff`  
**Pattern ID:** `VS-d25f622d`  
**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`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `heading-order` ([reference](https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 116 instances; 114 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">Report Information</h3>
```

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

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

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37313&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38814&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=33569&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=39853&lcdStatus=all&sortBy=title
- 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
- https://cms.gov/apps/aha/license.asp?file=%2Ffiles%2Fzip%2Fi%2Foce-quarterly-data-files-v263r0.zip
- https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=40210&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=34924&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-procedure-procedure-ptp-edits
- https://cms.gov/apps/aha/license.asp?file=%2Ffiles%2Fzip%2Fi%2Foce-quarterly-data-files-v241r0.zip
- https://www.cms.gov/medicare/physician-fee-schedule/search/overview
- https://www.cms.gov/medicare/payment/covid-19-vaccine-toolkit/medicare-covid-19-vaccine-shot-payment
- https://www.cms.gov/medicare/physician-fee-schedule/search
- https://www.cms.gov/nosurprises
- https://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=all&docType=F&keyword=psych&keywordType=all&lcdid=39799&sortBy=relevance
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2Fdownloads%2F2019-July-NOC-Pricing-File.zip
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=39242&lcdStatus=all&sortBy=title
- https://cms.gov/medicare/coverage/summary-notice
- http://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=38649&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-contractor-report.aspx?contractorName=all&contractorNumber=all&lcdid=39614&lcdStatus=all&sortBy=title
- http://www.cms.gov/priorities/health-equity/minority-health/resource-center/language/french-francais
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38743&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=36524&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33736&lcdStatus=all&sortBy=title

…and more — 114 pages total ([download CSV](csv/axe-core__heading-order.csv)).

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

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=37313&lcdStatus=all&sortBy=title
- https://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38814&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=33569&lcdStatus=all&sortBy=title

---

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

**Bug ID:** `VS-8dde0e06`  
**Pattern ID:** `VS-d5d82446`  
**URL:** https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.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:** 106 instances; 106 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<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
1. Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.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/version39-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0120.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0482.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html
- http://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0018.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0057.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0286.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0157.html
- https://cms.gov/icd10m/version40-fullcode-cms/fullcode_cms/P0005.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0219.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0488.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0672.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0289.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0013.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html

…and more — 106 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/version39-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html

---

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

**Bug ID:** `VS-2fef1a2b`  
**Pattern ID:** `VS-f18df681`  
**URL:** https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.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:** 1507 instances; 106 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 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 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
1. Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.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/version39-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0120.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0482.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html
- http://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0018.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0057.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0286.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0157.html
- https://cms.gov/icd10m/version40-fullcode-cms/fullcode_cms/P0005.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0219.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0488.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0672.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0289.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0013.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html

…and more — 106 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/version39-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html

---

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

**Bug ID:** `VS-50cc258f`  
**Pattern ID:** `VS-0ba8ce9d`  
**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"]`  
**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:** 280 instances; 14 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

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

### Affected pages
- https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html
- http://www.cms.gov/medicare-coverage-database/details/medicare-coverage-document-details.aspx?bc=AgAEAAAAAAAAAA%3D%3D&MCDId=26&MCDIndexType=3&mcdtypename=National+Benefit+Category+Analyses
- https://www.cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?areaId=all&bc=1&contractOption=all&docType=NCA%2CCAL%2CNCD%2CMEDCAC%2CTA%2CMCD%2C6%2C3%2C5%2C1%2CF%2CP&fromTracking=Y&keyword=permanent+cardiac&keywordType=starts&ncaid=246&proposed=Y&sortBy=relevance
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=265&proposed=Y
- https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=204
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=264&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=237&proposed=N
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=33&sortBy=meetingdate&year=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=58&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N
- https://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=187&proposed=N
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=281&proposed=N

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html

---

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

**Bug ID:** `VS-ddafd7b0`  
**Pattern ID:** `VS-fa44f293`  
**URL:** http://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program  
**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:** 12 instances; 12 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<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
1. Open http://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program.
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
- http://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/medicaid-chip/community-engagement-support/eligibility-made-easy
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.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/P0448.html
- https://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1518.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1352.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0139.html
- https://www.cms.gov/medical-bill-rights
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html

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

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

### Example pages
- http://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/medicaid-chip/community-engagement-support/eligibility-made-easy
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1323.html

---

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

**Bug ID:** `VS-bbb55d53`  
**Pattern ID:** `VS-8806389c`  
**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)`  
**WCAG SC:** _undetermined_  
**Rule:** axe-core — `landmark-unique` ([reference](https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 1609 pages affected
  
**History:** first seen 2026-W25, last seen 2026-W40 (16 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 1 of 1609 scanned pages (1 instances).

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

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

### Affected pages
- http://www.cms.gov/apps/media/press/factsheet.asp?Counter=4474&page=1

### 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

---

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

**Bug ID:** `VS-3323625b`  
**Pattern ID:** `VS-0066c67d`  
**URL:** https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.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:** 104 instances; 104 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<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
1. Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0178.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/version39-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html
- https://cms.gov/icd10m/FY2025-NPRM-Version42-fullcode-cms/fullcode_cms/P0028.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0120.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0217.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0482.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html
- http://cms.gov/icd10m/FY2023-version40-fullcode-cms/fullcode_cms/P0018.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0057.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0286.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0157.html
- https://cms.gov/icd10m/version40-fullcode-cms/fullcode_cms/P0005.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0219.html
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0488.html
- http://cms.gov/icd10m/FY2024-version41-fullcode-cms/fullcode_cms/P0672.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0289.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- http://www.cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0088.html
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0013.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html
- http://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals/r13270cp
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html

…and more — 104 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/version39-fullcode-cms/fullcode_cms/P0178.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P1836.html
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0974.html

---

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

**Bug ID:** `VS-d20c69a7`  
**Pattern ID:** `VS-d69fc059`  
**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)`  
**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:** 15 instances; 9 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### HTML snippet
```html
<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
1. Open https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273.
2. Locate the element: .MsoNormalTable[border="1"]:nth-child(90) > 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://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html
- http://cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=33&sortBy=meetingdate&year=all
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=58&proposed=N
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=36889&lcdStatus=all&sortBy=title&ver=24
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?bc=ABAAAAAAIAAA&NCAId=299&ncdid=281&ncdver=8&type=Open
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=36868&ver=20
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=314&proposed=N

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

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

### Example pages
- https://cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?bc=AAgAAAAACAAA&NCAId=273
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1144.html
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P1186.html

---

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

**Bug ID:** `VS-beaaa8b1`  
**Pattern ID:** `VS-7118fead`  
**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`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r61` ([reference](https://alfa.siteimprove.com/rules/sia-r61))  
**Severity:** Moderate  
**Frequency:** 146 instances; 146 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

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

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

### Affected pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3
- https://www.cms.gov/about-cms/what-we-do/emergency-response/how-can-we-help
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- https://cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_cr_number&page=12&sort=asc
- 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
- https://www.cms.gov/about-cms/information-systems/privacy/privacy-act-1974-and-privacy-act-requests
- https://www.cms.gov/about-cms/contact/database?page=206
- https://www.cms.gov/priorities/innovation/cgt-access-model-frequently-asked-questions
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55451&ver=2
- https://www.cms.gov/marketplace/about/exchange-coverage-maps
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60176&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=34051&lcdStatus=all&sortBy=title&ver=43
- http://www.cms.gov/medicare/medicaid-coordination/states/medicaid-integrity-program
- https://www.cms.gov/cms-l564-request-employment-information
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34833&lcdStatus=all&sortBy=title&stateRegion=all&ver=94
- https://cms.gov/medicare/cms-forms/cms-forms/cms-forms-items/cms056691
- https://www.cms.gov/
- https://cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals/r13280cp
- https://www.cms.gov/data-research/cms-information-technology/sparc/how-to-use-sparc/step-1-sparc-scope
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10720otn
- https://www.cms.gov/training-education/medicare-learning-networkr-mln/resources-training/mln-publications-multimedia
- https://www.cms.gov/medicare/advantage-quality-improvement-program/objectives

…and more — 146 pages total ([download CSV](csv/alfa__sia-r61.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=310&ncdver=3

---

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

**Bug ID:** `VS-92a192fd`  
**Pattern ID:** `VS-c18be945`  
**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"`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r57` ([reference](https://alfa.siteimprove.com/rules/sia-r57))  
**Severity:** Moderate  
**Frequency:** 60 instances; 60 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

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

### Affected pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
- https://www.cms.gov/about-cms/what-we-do/emergency-response/how-can-we-help
- https://cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_cr_number&page=12&sort=asc
- https://www.cms.gov/about-cms/information-systems/privacy/privacy-act-1974-and-privacy-act-requests
- https://www.cms.gov/priorities/innovation/cgt-access-model-frequently-asked-questions
- https://cms.gov/medicare/cms-forms/cms-forms/cms-forms-items/cms056691
- https://www.cms.gov/
- https://cms.gov/regulations-and-guidance/guidance/transmittals/transmittals/r10720otn
- https://www.cms.gov/training-education/medicare-learning-networkr-mln/resources-training/mln-publications-multimedia
- https://www.cms.gov/medicare/advantage-quality-improvement-program/objectives
- https://www.cms.gov/newsroom/press-releases/la-administracion-trump-reduce-las-primas-de-medicare-advantage-y-la-parte-d-para-personas-adultas
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_subject_formatted&page=12&sort=desc
- https://www.cms.gov/newsroom/fact-sheets/suppliers-selected-new-program-reduces-costs-certain-durable-medical-equipment
- https://cms.gov/newsroom/press-releases/hhs-transform-care-delivery-patients-chronic-kidney-disease
- https://www.cms.gov/medicare/quality/initiatives/hospital-quality-initiative/hospital-compare
- https://www.cms.gov/newsroom/press-releases/medicare-issues-new-guidance-insurance-companies-medicare-mailings
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2014-transmittals-items/r2858cp
- https://www.cms.gov/apps/aha/license.asp?file=%2Ffiles%2Fzip%2FIOCE-PC-Software-Package-V23R0.zip
- https://cms.gov/regulations-and-guidance/guidance/transmittals/2014-transmittals-items/r530pi
- https://www.cms.gov/training-education/partner-outreach-resources/american-indian-alaska-native/ltss-ta-center/information/ihs-tribal-and-urban-ltss-programs
- http://www.cms.gov/data-research/computer-data-systems/esmd/esmd-medicare-providers-and-suppliers
- http://cms.gov/medicare/regulations-guidance/provider-reimbursement-review-board
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2021-transmittals?page=12
- https://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medicaid-integrity-program/education/resource-library/palliative-care-vs-hospice-care
- http://cms.gov/medicare/medicare-fee-for-service-payment/dmeposcompetitivebid/competitive_acquisition_ombudsman_faq

…and more — 60 pages total ([download CSV](csv/alfa__sia-r57.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare/regulations-guidance/transmittals/2025-transmittals?items_per_page=25&order=field_dyna_revision_date&page=13&sort=asc
- https://www.cms.gov/about-cms/what-we-do/emergency-response/how-can-we-help
- https://cms.gov/medicare/regulations-guidance/transmittals/2015-transmittals?items_per_page=25&order=field_dyna_cr_number&page=12&sort=asc

---

## Headings are structured hierarchically (WCAG criterion undetermined)

**Bug ID:** `VS-0642f1ce`  
**Pattern ID:** `VS-f054f4a4`  
**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">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r53` ([reference](https://alfa.siteimprove.com/rules/sia-r53))  
**Severity:** Moderate  
**Frequency:** 53 instances; 53 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

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

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

### Affected pages
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- 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
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=55451&ver=2
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60176&ver=9
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39644&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=34833&lcdStatus=all&sortBy=title&stateRegion=all&ver=94
- 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
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52505&ver=77
- http://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=39276&lcdStatus=all&sortBy=title&ver=8
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33736&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56471&articleStatus=all&bc=3&sortBy=title&ver=18
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59434&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- https://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38371&lcdStatus=all&sortBy=title&ver=10
- https://www.cms.gov/apps/aha/license.asp?file=%2Ffiles%2Fzip%2FIOCE-PC-Software-Package-V23R0.zip
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33830&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=35073&ver=51
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=26
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56614&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/lcd.aspx?bc=7&contractorName=all&contractorNumber=all&lcdid=35080&lcdStatus=all&sortBy=title&ver=53
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=20
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38773&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=6&lcdid=38435&lcdStatus=all&sortBy=title&ver=12
- https://www.cms.gov/apps/ama/license.asp?file=%2FMedicare%2FMedicare-Fee-for-Service-Part-B-Drugs%2FMcrPartBDrugAvgSalesPrice%2FDownloads%2F2017-April-NOC-Pricing-File.zip

…and more — 53 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
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59330&articleStatus=all&bc=3&sortBy=title&ver=6
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdId=38805&ver=7
- 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

---

## Table header has scope (WCAG criterion undetermined)

**Bug ID:** `VS-18fe8f1b`  
**Pattern ID:** `VS-2cd767ca`  
**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">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r78` ([reference](https://alfa.siteimprove.com/rules/sia-r78))  
**Severity:** Moderate  
**Frequency:** 52 instances; 35 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

### Steps to reproduce
1. 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.
2. Locate the element: <h3 id="navStickyHeader" class="bg-white d-inline expand-head-pad">
3. Confirm the Siteimprove Alfa finding for rule sia-r78.

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

### Affected pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60176&ver=9
- https://www.cms.gov/cms-l564-request-employment-information
- https://www.cms.gov/
- 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
- http://cms.gov/icd10m/FY2026-fr-v43.1-fullcode-cms/fullcode_cms/P0668.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0250.html
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33736&lcdStatus=all&sortBy=title
- https://cms.gov/icd10m/fy2025-version42.0-fullcode-cms/fullcode_cms/P0049.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56471&articleStatus=all&bc=3&sortBy=title&ver=18
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=59434&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=22
- http://cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=33830&lcdStatus=all&sortBy=title
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=26
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56614&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=23
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=56497&articleStatus=all&bc=3&sortBy=title&ver=20
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0052.html
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=38773&lcdStatus=all&sortBy=title
- https://cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0221.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0014.html
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-alphabetical-report.aspx?lcdid=34149&lcdStatus=all&sortBy=title
- https://www.cms.gov/medicare-coverage-database/search-results.aspx?areaId=all&contractOption=name&contractorName=5&docType=NCA%2CCAL%2CNCD%2CMEDCAC%2CTA%2CMCD%2C6%2C3%2C5%2C1%2CF%2CP&keyword=defining&keywordType=starts&lcdid=40410&sortBy=relevance
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56425&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=15
- http://www.cms.gov/icd10m/version38-fullcode-cms/fullcode_cms/P0117.html
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=57863&articleStatus=all&bc=4&contractorName=all&contractorNumber=all&sortBy=title&ver=41
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=58747&articleStatus=all&bc=3&sortBy=title&ver=63

…and more — 35 pages total ([download CSV](csv/alfa__sia-r78.csv)).

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

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

### Example pages
- https://www.cms.gov/medicare-coverage-database/reports/local-coverage-final-lcds-state-report.aspx?contractorNumber=all&lcdid=38835&lcdStatus=all&sortBy=title&stateRegion=all
- https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=60176&ver=9
- https://www.cms.gov/cms-l564-request-employment-information

---

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

**Bug ID:** `VS-ceea4b4b`  
**Pattern ID:** `VS-04a9d28c`  
**URL:** https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html  
**XPath / selector:** `img`  
**WCAG SC:** _undetermined_  
**Rule:** deprecated-html — `presentational-attr`  
**Severity:** Moderate  
**Frequency:** 205 instances; 19 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

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

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

### Steps to reproduce
1. Open https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html.
2. Locate the element: img
3. Confirm the deprecated-html finding for rule presentational-attr.

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

### Affected pages
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0120.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?bc=17&ncacaldoctype=all&ncaid=282&sortBy=status&status=all
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0488.html
- https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?bc=8&contractorNumber=all&lcdid=37062&lcdStatus=all&sortBy=title&stateRegion=all&ver=25
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0087.html
- http://cms.gov/icd10m/FY2026-nprm-version43-fullcode-cms/fullcode_cms/P0220.html
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0603.html
- https://www.cms.gov/medicare-coverage-database/view/medcac-meeting.aspx?bc=15&medcacid=37&sortBy=meetingdate&year=all
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=52800&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=98
- http://cms.gov/icd10m/version36-fullcode-cms/fullcode_cms/P0050.html
- https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P0139.html
- http://www.cms.gov/icd10m/version37-fullcode-cms/fullcode_cms/P0380.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0759.html
- https://cms.gov/icd10m/version38-0-R1-fullcode-cms/fullcode_cms/P2028.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0358.html
- http://cms.gov/medicare-coverage-database/view/article.aspx?articleid=55136&articleStatus=all&bc=5&contractorNumber=all&sortBy=title&stateRegion=all&ver=19
- http://www.cms.gov/icd10m/version%20371r1-fullcode-cms/fullcode_cms/P0032.html
- https://cms.gov/icd10m/FY2026-fr-v43-fullcode-cms/fullcode_cms/P0247.html

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

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

### Example pages
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0664.html
- https://cms.gov/icd10m/version39-fullcode-cms/fullcode_cms/P0120.html
- https://www.cms.gov/medicare-coverage-database/view/ncacal-public-comments.aspx?bc=17&ncacaldoctype=all&ncaid=282&sortBy=status&status=all

---

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

**Bug ID:** `VS-6f4ec9bc`  
**Pattern ID:** `VS-f2542d87`  
**URL:** http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=58&proposed=N  
**XPath / selector:** `<pre>`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r79` ([reference](https://alfa.siteimprove.com/rules/sia-r79))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 1609 pages affected
  
**History:** first seen 2026-W24, last seen 2026-W40 (17 weeks)

### Description
Duplicate role landmark is labeled. Detected by Siteimprove Alfa rule sia-r79 on 1 of 1609 scanned pages (1 instances).

### Steps to reproduce
1. Open http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=58&proposed=N.
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
- http://cms.gov/medicare-coverage-database/view/ncacal-decision-memo.aspx?ncaid=58&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

---

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

**Bug ID:** `VS-d6bcda0c`  
**Pattern ID:** `VS-7fbb8b20`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html  
**XPath / selector:** `{"type":"document","children":[{"type":"element","children":[{"type":"element","`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r59` ([reference](https://alfa.siteimprove.com/rules/sia-r59))  
**Severity:** Moderate  
**Frequency:** 1 instances; 1 of 1609 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W40 (14 weeks)

### 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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.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/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

---

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

**Bug ID:** `VS-f1539438`  
**Pattern ID:** `VS-e43903a1`  
**URL:** https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.html  
**XPath / selector:** `<ul id="globar">`  
**WCAG SC:** _undetermined_  
**Rule:** Siteimprove Alfa — `sia-r75` ([reference](https://alfa.siteimprove.com/rules/sia-r75))  
**Severity:** Moderate  
**Frequency:** 2 instances; 1 of 1609 pages affected
  
**History:** first seen 2026-W26, last seen 2026-W40 (14 weeks)

### 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
1. Open https://www.cms.gov/icd10m/version33-fullcode-cms/fullcode_cms/P1360.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/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